5 ways companies are innovating in healthcare

Walmart senior leadership regularly hears from their customers that they’re concerned about health, the cost of care and access to quality healthcare services. The organization believes it’s their responsibility to do more.

From large employers like Walmart, down to those with smaller employee populations, addressing a fragmented and expensive healthcare system is a top priority.

Premise Health recently hosted 132 clients from 80 large employers in Nashville to connect them with their peers, share success stories and strategies, and discuss the state of the evolving healthcare industry. Attendees included HR leaders focused on benefits and total rewards; employee health, wellness and safety; and talent and retention. Here are five takeaways on the state of healthcare from some of the world’s largest employers.

Employers are done with fee-for-service
Employers project their healthcare benefit costs to reach nearly $15,000 per employee this year alone. Misaligned incentives between employers, who are the ultimate payor, and the providers in their communities lead to unnecessary spending and an inefficient system. This uncontrollable expense leads to the question, can anyone truly fix healthcare? No group has been successful to date, and individuals don’t hold the power to single-handedly overturn the system.

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Reality is, employers are in a unique position to demand a shift toward aligned incentives. They’re investing in strategies that create healthcare value for their populations, like bringing care at or near where an employee works, greatly improving access, generating cost savings and promoting healthier populations.

Transparency and accountability matter
In healthcare, costs continue to rise while utilization declines. It is a misaligned equation, and employers want transparency and accountability.

We are in an era of disintermediation, and employers are holding partners more accountable. For example, local health systems are hard-pressed to demonstrate they can deliver quality care that improves outcomes at lower costs; health plans are feeling the heat for negotiating cost effective rates with affordable premiums; and pharmacy benefit managers (PBM) are under fire for operating behind closed doors.

Employers recognize full transparency into price and quality is a difficult undertaking for health systems. But they’re past the point of caring — they wanted transparency yesterday.

In data we trust?
Organizations are paying more attention to data and the value it can deliver. As employers hold their partners more accountable, we’re beginning to see an increase in performance guarantees. Late last year, GM announced a direct contract deal with Henry Ford Health System, which holds the health system responsible for hitting key quality, cost and utilization of services metrics.

Benefits managers know healthcare costs are largely driven by referral patterns. They are exploring partnerships with organizations who can accurately combine claims and electronic health record data, among other sources, to uncover quality, low cost providers with the best outcomes. These relationships are mutually beneficial for employers looking to control costs and employees in need of complex procedures.

Engagement is critical
Workplace wellness programs are resulting in healthier behaviors, but there is no correlation with improved outcomes, according to a recent study. Yet behavior change is critical for employers hoping to improve the health of their populations.

To address behavior change, employers are improving access to resources that meet their employees where they are. An application or fitness program is only a band aid layered on top of a far more complex, deeply rooted issue without benefits to support and sustain the resources. For employers, it requires going beyond an app. As anyone who treats patients knows, technology must be combined with convenient access to care to be effective.

Integration is the key ingredient
Employers are striving to offer integrated primary services to their employees, understanding integration is key to better outcomes and lasting behavior change. Gone are the days of setting up a stand-alone occupational health clinic to treat workplace injuries. Offering access to complementary services, such as primary care, occupational health and physical therapy, is key to better outcomes, and ultimately, lower costs.

Employers know this, which is why they keep an eye on their populations and unique cost drivers. Lots of back pain? You should look at better access to physical therapy for your population.

Employers foot the bill for half of the population — nearly 160 million Americans — putting them in a position to shake up the industry. We expect they will take an increasingly proactive approach, demanding access to high-quality care providers, transparency and accountability.

Can employers fix healthcare? We believe the answer is yes.

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