Hybrid care models, affordability, health equity, and behavioral health emerge as top focus areas for plan sponsors and consumers.
Consumers were in touch with their health needs and open to new options for care in 2022. Still, they faced challenges navigating new settings, contending with rising costs, and bypassing barriers to care.
Plan sponsors have an opportunity to guide consumers through their health care journey. Our market research identified three key insights in our 2023 Health Care in Focus report that illustrate how.
1. Hybrid care options are key to consumers managing their health.
Virtual care has skyrocketed over the last few years. About 58% of consumers said they used virtual care in the past 12 months and 94% of them were satisfied with the care they received. It offers a convenient, cost-effective option, especially when symptoms are mild.
Advances in technology have moved clinical care beyond the exam room and into sites such as homes, places of work, and retail locations. But half of consumers said they were concerned care would lose quality outside traditional settings. By contrast, just 30% of employers and 25% of health plan leaders shared the concern.
Consumers said they struggled to navigate benefits. If they don’t know how and where to get care, they may put it off, leaving conditions unmanaged and causing costs to rise for them and their plans. Plan sponsors need to educate consumers about hybrid models and encourage them to use technology to achieve greater control of their health.
2. Confronting rising health care services costs is key to addressing health equity.
The conversation about health equity has intensified amid escalating costs and the continued influence of social determinants of health (SDOH) on the delivery of care.
About 75% of consumers said they were concerned about unaffordable medical costs in 2022, compared with 69% in 2020.
Significantly, 71% of consumers expressed concern about the expense of prescription medications. To this end, generic medications offer a cost-effective alternative, while new biosimilar medications hold promise to lower costs when they come on the market. It’s important for plan sponsors to educate members on new medications to encourage adoption.
Ensuring access to low-cost medications is one of the ways consumers said they expected employers to improve access to health care in general. They also expected affordable premiums, paid sick leave benefits, manageable out-of-pocket costs, and wages that keep pace with the cost of living.
Plan sponsors believe they play a role in reducing barriers. Their efforts remain uncoordinated, however, due to the volume and complexity of related issues. As they work toward the shared goal of health equity, their challenge will be to align on an effective strategy.
3. Plan sponsors can clear the path to behavioral health.
More people are talking about – and seeking – behavioral health treatment. Despite general satisfaction with support and benefit offerings, consumers reported challenges with access. These included long wait times, lack of coverage, and obstacles to in-person care.
Of note, younger consumers gravitated toward behavioral health treatment, with Gen Z consumers ages 18-24 more than twice as likely than Baby Boomer consumers ages 57-75 to seek care.
Plan sponsors said they were committed to delivering behavioral health options, although they overestimated consumer satisfaction. While 85% of employers and 84% of health plan leaders said they believed consumers were satisfied, just 68% of consumers said they were satisfied.
Meanwhile, 43% of consumers said their mental health declined over the past year.
Plan sponsors have an opportunity to listen to consumers’ changing behavioral health needs. One strategy could be age-specific outreach. Through discussion, plan sponsors can understand how best to support consumers going forward.
Each of the three key insights emphasizes the essential role of connecting with consumers.
Click here to access the full 2023 Health Care in Focus report and download the executive summary.
The research methodology: In Q4 2022, Evernorth Health Services partnered with Ipsos to conduct a nationwide survey of more than 3,000 consumers with employer-sponsored health insurance. The study also surveyed 575 employers who select and manage employee benefits for their organization, along with 75 health plan leaders who determine the benefits partners and suppliers that a health plan offers to groups and clients.
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