Ten Things to Know From the NBGH Employer Survey

By Clive Riddle, August 16, 2019

The National Business Group on Health has released their annual study - The 2020 Large Employers' Health Care Strategy and Plan Design Survey, which found “employers project the total cost of health benefits will rise 5% in 2020, taking cost management initiatives into account. That increase is identical to 2019’s projected increase - but actual costs are coming in lower. Large employers reported the actual increase in 2018 was 3.6%.”

For comparison, PwC's Health Research Institute in their June report: Medical cost trend: Behind the numbers 2020, projected which projects the 2020 trend to be a six percent cost increase.  In late July Milliman released their 2019 Milliman Medical Index, a 12-page report and their 15th annual analysis that "measures healthcare costs for individuals and families receiving coverage from an employer-sponsored preferred provider plan (PPO). For 2019, they found overall healthcare costs for a hypothetical family of four have reached $28,386, an increase of 3.8% from the year prior.

Here’s ten things to know from this year’s NBGH study:

1. Total cost of health care per employee including premiums and OOP is estimated to be $14,642 for 2019 and $15,375 in 2020.
2. The employers will cover contribution is about 70% of costs while employees will bear about 30%, 
3. 44% of employers ranked musculoskeletal issues as the top condition impacting their costs. 85% ranked it among the top three conditions.
4. The top two listed large employer initiatives for 2020 were: (1) Implement more virtual care solutions - 51%; (2) More focused strategy on high-cost claims - 39%
5. 31% of employers plan to implement an ACO or high performance network in select markets in 2020
6. 49% of employers plan to pursue an advanced primary care strategy in 2020, and another 26% are considering one by 2022.
7. 34% of employers will deliver advanced primary care through an onsite or near-site health center 
8. 85% of employers rate high-cost drugs as the number one or two most concerning pharmacy issues.
9. 20% of employers will have a point of sale prescription rebate program in 2020, but 67% favor a model based on net price of medications with no rebate as an alternative.
10. The number of employers offering full replacement consumer-directed health plans will shrink to 25% in 2020, down from 30% this year and 39% in 2018.