High Demands and High Costs: Striking a Balance for a Sustainable Future 

Each year Mercer hosts a Healthcare Innovation Symposium to bring employers and innovators together to discuss issues that will shape the future of employer-sponsored health programs. The focus of this year’s symposium was, in a word, balance – finding ways to innovate to improve health outcomes and member experience while acknowledging mounting budget pressures. In this post, we’ll share some highlights from the first day.

Incremental changes can lead to healthcare ecosystem change

Representatives of four health organizations – CVS Health, Kaiser Permanente, Northwell Direct, and The Clinic by Cleveland Clinic – weighed in on some incremental changes they believe will have a big impact on healthcare delivery within employer-sponsored health programs.

• Digital innovation can drive quality care and outcomes. Virtual care was catapulted to the frontline of health transformation as we navigated COVID-19. Technology can enable a better, higher-quality healthcare experience if it is well-integrated with in-person care. Virtual second opinions and virtual specialty care can help improve care delivery and outcomes by reducing misdiagnoses, aligning care to the member’s needs, and standardizing outcomes and diagnostic accuracy.
• Primary care alternatives. Given the looming shortage in primary care providers, now is the time to proactively integrate virtual care within the healthcare delivery experience. Virtual primary care is just one way that employers can offer primary care services to members in an efficient healthcare delivery model – with in-person care still available when it is necessary.
• Direct contracting locally can help with affordable healthcare nationwide. Employers are not the only stakeholders seeking change; healthcare organizations across the ecosystem are looking for ways to improve quality, outcomes, and experience. As such, direct contracting with health systems can be an effective way to offer high quality, affordable care through organizations that have a strong community presence and recognizable name. Nationally, this very local strategy can be deployed by working with health systems in areas where you have large concentrations of employees. 
• Integrated patient experience through value-based care can improve health outcomes. Keeping the member at the center of their care by interconnecting digital care with brick and mortar care has the potential to not only improve their health outcomes and experience, but also may improve provider efficiency. The goal of this care is to give the patient 360˚ care that treats the entire condition in a seamless way for the patient. Value-based care offers a data-driven opportunity to improve health outcomes and lower costs at the same time.

There’s opportunity for action!

Whether you’re looking for action that you can take today, or preparing for the healthcare system of the future, there are opportunities to take action. During the event, participants discussed and further developed ideas that can help move health programs forward without breaking the bank:

Act now with steps you can take today:

• Prepare for the biosimilar explosion
• Analyze provider quality with plan provider performance metrics
• Explore including clinical trials in your plans

Keep watch on trends that are evolving today and may impact employers in the next few years:

• Review what smart networks are available in your markets
• Analyze your networks for direct contracting opportunities
• Look at split-deductible plans as a way to reduce member cost pressure

Stay alert to developments that may shape the future:

• Private equity’s impact on healthcare costs – employers can get involved in lobbying for changes
• Virtual reality in healthcare – are your virtual healthcare providers ready?
• “True flex” – is this a way to deliver diverse healthcare to your diverse workforce?

Interested in any of the ideas we developed? Or would you like to get on the invite list for the 2024 Innovation Symposium? Send us an email at Mercer’s Center for Health Innovation.