By: Anthony Defail, MD; Chronis Manolis, RPh; and Elizabeth Riordan
If 2023 was the year of employers surviving and thriving on the coattails of the “Great Reassessment,” 2024 is looking to be the year of meeting a workforce of shifting demographics and evolving expectations as paramount to attracting and retaining talent. At a recent panel discussion hosted by The Pittsburgh Business Times, speakers from the Pennsylvania Chamber of Business and Industry, UPMC Health Plan, and St. Francis University shared that one silver lining of the pandemic is the evolution of the way payers and employers offer employee benefits. The rapid advancement of data and technology, shifting societal norms that place higher value on one’s wellbeing, and a renewed collective focus on striving to make our society more equitable have all had an indelible impact on “business as usual.” These shifts have also shaped the workforce landscape and impacted employers’ decision making when it comes to offering competitive benefits packages.
Immigration and visa policy, criminal justice reform, and training also comprise the multi-faceted workforce development toolkit that can help close the employment gap and empower employers’ workforce development efforts. Benefits remain a critical tool that employers can have a direct hand in shaping and tailoring to their specific workforces. How we navigate the current workforce landscape is not limited to individual businesses – our ability to innovate and adapt will shape the future of our businesses and communities in Pennsylvania.
What is top of mind for the 2024 workforce? What do Pennsylvania employers need to know about the benefits landscape for 2024 and beyond?
THE 2024 WORKFORCE: SHIFTING EMPLOYEE DEMOGRAPHICS AND EXPECTATIONS
Millennials now make up the majority of the workforce in all industry sectors, and Gen Z continues to mature into adulthood, as many are entering the workforce for the first time. As Baby Boomers approach retirement age, we are in the throes of a “severe” workforce crisis with only 66 available workers to fill every 100 open jobs in Pennsylvania. In many sectors across the state and nation, fully remote and hybrid work is the new normal, presenting both novel challenges and opportunities.
With the shift in workforce demographics comes a change in employee values – younger generations have different expectations of their employer than in generations past. Managing a hybrid workforce presents new challenges, some of which may be managed effectively by the employer’s Employee Assistance Program (EAP) benefit. Global and national events over the past half decade have led to a renewed societal focus on equity as a beacon of the way forward in all that we say and do – for benefits, this translates to affordable improved access that is continuous and meets both medical and non-medical needs. The pandemic trend of renewed focus on employee wellbeing is here to stay, and with it comes an opportunity for employers to consider how they might foster a culture of sustained health improvement focused on equitable whole-person care.
BENEFITS: THE EMPLOYER’S MVP RECRUITMENT AND RETENTION TOOL
In 2024, the best benefits packages will be affordable, flexible, customizable, and data-informed; and include access to offerings that focus not only on management of conditions and medications, but also the employee’s wellness and overall well-being. Here are some recommendations for employers seeking to offer competitive benefits packages and shape a future for health care in Pennsylvania that empowers both businesses and individuals to succeed and flourish.
Harness the data tsunami’s power and potential
A good employer will tell you their most valuable resource is their people. A great employer knows their second-most valuable resource is data.
Thirty percent of the world’s data volume is dominated by the healthcare industry, and that margin is growing quickly. Combining this data with workforce data and leveraging it all to become “actionable” makes differences in lives and the bottom line. Actionable data provides a full picture of an employee and the workforce they represent and optimizes the employer’s ability to manage productivity and costs.
Actionable data provides information that can be used to directly impact outcomes and track improvements, and it helps inform employers on how to best customize benefits that fit their company culture and the individuals in their workforce. Data around benefit utilization, behavior patterns, and employee feedback allow employers to tailor benefits packages to meet not only their workforce’s unique needs but also the needs of individuals through the ability to personalize programs. Whether it’s preventive screenings, chronic disease management, or mental health support, personalized programs also demonstrate the employer’s commitment to individual well-being.
Workpartners®, a national commercial product of UPMC Insurance Services Division, is known for its predictive analytics that look at health outcomes with a performance lens and help employers understand the factors on which they should focus to optimize their workforce, both today and into the future. In addition to using data towards managing the health of the larger workforce, they can pinpoint individual employees who might benefit from preventative and support services. Additionally, through Workpartners’® EAP known as LifeSolutions®, managers have access to trained counselors who can help them recognize early signs of mental health stressors and build their confidence in knowing when and how to engage EAP services.
The Integrated Delivery and Finance System model under which UPMC’s payer and provider arms operate allows for the fluid exchange of data to inform efficient and effective benefits utilization. For example, through UPMC’s Premier Partners Program, we take a phased approach to implementing value-based models for hospitals, facilities, and providers with the goal of helping providers progress along the spectrum of risk from pay-for-performance to gain sharing. Since its beginnings in 2011, this program has reduced unplanned care, coordinated care more effectively, bridged gaps by integrating physical and behavioral health, and proactively supported compliance for members whose providers participate in the Premier Partners Program.
Embrace the evolving concept of the “employee benefits package”
Administering benefits is no longer enough as the concept of “employer benefits package” is a moving target, continually being informed by societal influences, data, and advances in technology.
Employees increasingly seek a customized “boutique” of benefit offerings, akin to how they might custom order products and services online and access banking and entertainment. Digital benefits products expand possibilities for the boutique benefit utilization. For example, not every behavioral health issue requires a full visit with a therapist. At UPMC Health Plan, members have several options for accessing behavioral health care – they might engage with the RxWell app to digitally connect with wellness coaches, connect with EAP services for situational needs, and/or schedule telehealth visits with therapists. Not only does this variety of options increase access beyond tradition in-person provider visits, it can also impact employee productivity by factoring travel time out of care access.
As the saying goes, “an ounce of prevention is worth a pound of cure.” This wisdom holds true for utilization of benefits. At UPMC Health Plan, we translate this adage to “know us before you need us” and “we offer services to keep you well in addition to covering expenses when you when you are sick.” Research shows that coverage confirmation, the moment when an employee’s insurance card arrives in the mail, is the “peak” experience of individuals on their health insurance coverage journey and is associated with “relief”. We leverage that peak by offering preventive care activities and education at the beginning of coverage with the intent of engaging members in health promotion/disease prevention activities and keeping them engaged. Using data analytics, we personalize this experience by recommending the “next best action” in the wellness journey – similar to the way streaming platforms make movie suggestions to subscribers.
Competitive employer benefits packages must keep pace with UPMC’s 21st-century world of convenience and be adaptable to a society that is “on and accessible,” 24/7. The pandemic fast-forwarded the development and uptake of new digital health possibilities for 24/7 access to care, and offering this access not only meets employee needs – it can also optimize their productivity. “Hybrid” access models continue to emerge across specialties allowing flexible options for provider appointments – fostering a true sense of meeting employees where they are.
Choose health benefits plans that use data to offer innovative “wraparound” care
The state of health care in the U.S. is fragmented at best. Employers can shield their workforce from bearing the brunt of this fragmentation by choosing plans that demonstrate payer-provider partnerships and engage employees in accessing care in innovative ways. Today’s best health insurance plans offer more than just expense coverage – they are built to incorporate wraparound care that fosters continuity of care and leads to good health outcomes.
At UPMC Health Plan, our Integrated Delivery and Finance System (IDFS) model supports built-in payer-provider partnerships, and that connection optimizes our ability to provide wraparound care. Some examples of wraparound care in action come from our Pharmacy and Care Management Departments.
Drug costs, driven by inflation and pharmaceutical innovation, can add up to 30 percent of a health plan’s total spend, and nationwide, employers will spend more than $600 billion on drugs alone in 2023. At UPMC Health Plan, we look to maximize the value of our drug benefit spend by leveraging data to provide wraparound care. We track member prescriptions and partner with Sempre Health to send medication refill reminders via text message, offering coupon copay discounts to members who complete the refill process on time. We pay PA Pharmacist Care Network (PPCN) pharmacists in community pharmacies where members fill their prescriptions as members of the health care team to provide in-person medication and chronic condition management services. We offer additional services that help optimize medication adherence and chronic condition management. For example, we have pharmacists on staff who are accessible to members 24/7 by phone or the Pharmacy tile on our AnywhereCare app. Data analytics also allows our pharmacists to flag members who could benefit from pharmacist and/or care manager follow-up proactively with members starting a new medication.
Similarly, analytics allows us to identify members who are new mothers and those with multiple co-morbidities (more than one chronic condition) and alert our care management team to proactively reach out to them to provide support and answer questions. Members accessing this wraparound care can connect with pharmacists and care managers by phone or video visits on our AnywhereCare app platform. Our IDFS model bridges access to provider data, ensuring that pharmacists and care managers on the payer side can provide care continuity with the wraparound services.
Lower prescription copays, foundational knowledge of new medications, and support for new parents and members experiencing multiple chronic conditions are just a sample of payer-provided wraparound services that pave the way to employee wellness and cost-effective care.
Look to equity as the true north
The pandemic ushered in a new era that includes increased focus on equity across all sectors and segments of our culture and society. Health care payers, providers, and policy makers are leading a movement towards adopting best practices to ensure more equitable health across our nation. Through measuring, reporting, and acting upon national measures of health care quality and equity like those captured by the Healthcare Effectiveness Data and Information Set (HEDIS®) measures, payers like UPMC Health Plan are making strides to innovate and embed components of health equity into their coverage, services, and programs.
Why is equity an important consideration for employers looking to attract and retain employees? Including health equity considerations in benefits packages optimizes the employer’s ability to promote care of the whole employee, which empowers the workforce to bring their whole selves to work. For example, social determinants of health, the conditions in which individuals are born, grow, work, live, and age, can account for up to 80 percent of an individual’s health outcomes. Unmet basic nonmedical needs, such as food and housing security, economic stability, and access to quality health services, can likewise compromise workforces and individual employees, which can lead to and compound poor and costly future health outcomes.
Access to care is also an important element of equitable health care, and telehealth offered through employer benefits helps break down barriers to care and levels the playing field across employees. In states that have large rural populations like Pennsylvania, well-developed telehealth services can connect employees with qualified health professionals, removing the once insurmountable physical barrier of geographic location.
Furthermore, championing value-based care models and promoting collaboration among all stakeholders, many employers and payers have already begun forging the path toward a more equitable health care system that also demonstrates greater efficiency, effectiveness, and sustainability.
The potential for employer benefits to foster a healthier, happier workforce is a worthy return on investment. How will you offer competitive benefits packages in 2024 and beyond?
Anthony Defail, MD, is Associate Vice President, Medical Services Commercial; Chronis Manolis, RPh, is Senior Vice President and Chief Pharmacy Officer; and Elizabeth Riordan, is Vice President of Strategic Business and Consumer Innovation, with UPMC Health Plan.
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