Q1 2024 Employer Healthcare Trends: Improving Care and Reducing Costs

Despite rising healthcare costs in the U.S., outcomes continue to worsen. For example, the U.S. has the highest rate of people with multiple chronic conditions and an obesity rate nearly double the Organisation for Economic Co-operation and Development (OECD) average, according to a brief published by The Commonwealth Fund.

To combat this, many employers are taking matters into their own hands by helping alleviate the healthcare cost burden for their employees, providing access to more personalized healthcare and offering nutrition education programs.

Read on to learn more about these key employer healthcare workforce trends.

According to the KFF 2023 Employer Health Benefits Survey, employers spent an average of $17,393 for family coverage per employee in 2023, an increase of nearly 48% over just a decade.

And despite employers paying more, employees still face high healthcare costs. In The Commonwealth Fund Health Care Affordability Survey, 43% of respondents with employer coverage reported it as somewhat or very difficult to afford healthcare, while 33% of respondents were currently paying off medical debt. As a result, employees delay or forgo necessary care.

Many companies seek alternative solutions to help manage the financial burden their workforce faces. Increasingly, employers are providing health services to their employees through health centers at or near their place of work.

The City of Sarasota’s Marathon Health center provides free or low-cost care to employees and their families who are enrolled in an insurance plan with the employer. Employees are further incentivized to visit the health center and participate in wellness challenges with the chance to earn money in an HSA or HRA.

“It’s really important that we care about the health of our employees and their families,” says Dominique Anderson, Human Resources General Manager for the City. “We want to make it more accessible for them to get the care that they need, and we don’t want them to delay care due to the cost.”

KFF’s 2023 Employer Health Benefits survey shows 16% of all employers with 50+ workers offer either onsite or near-site care clinics. This number increases for larger employers, up to 32% for firms with 5,000+ employees. But small to medium-size companies are buying in at an increasing rate, especially with shared near-site or network models.

Through these clinics, employees receive free or low-cost advanced primary care, free prescriptions, health coaching and care coordination services for specialists or services like MRIs. Primary care focused on prevention — with no provider incentive for additional visits or tests — keeps members healthier.

“Along with mitigating the cost for the employee, it also prevents conditions from getting worse,” says City of Sarasota Benefits Coordinator Kayla Nelson. “If we didn’t have the health center, employees might not pursue care, and end up getting sicker or even in the hospital.”

Another key benefit of employer-sponsored healthcare is the ability for providers to spend more time with their patients, personalizing the experience. The average Marathon Health appointment lasts 32 minutes, compared to 18 minutes in a traditional setting.

At the City of Sarasota’s health center, the doctor knows city employees by name. “Dr. Lyon never makes members feel rushed,” Anderson says. “He goes over diagnoses and bloodwork, and makes sure you understand everything and don’t leave the appointment feeling worried.”

This personalization drives better outcomes. Marathon Health data shows the following statistics for engaged patients:

• 23% decrease in emergency department use
• 19% reduction in high-risk blood pressure
• 17% reduction in moderate to severe depression
• 31% reduction in moderate to severe anxiety
• 59% of high-risk members make improvements on quality measures

“Instead of just saying, ‘Now you have high cholesterol, here’s the prescription,’ it’s about getting to know the person and understanding what’s important to them and where they need support,” says Silvia Madrigal, FNP, regional VP of clinical leadership at Marathon Health.

Dr. Amy Sachau, market clinical lead at Marathon Health, notes the extra time allows her to utilize motivational interviewing to find out patients’ reasons for taking care of their health, as well as build a relationship.

For a patient with diabetes, Dr. Sachau discovered he wanted to be healthy in retirement and spend time with his grandchild. “He became very engaged in his healthcare, and he got his hemoglobin A1c from 12 down to the sixes,” she says. “In fact, I was pulling medicines away because his blood sugars were getting too low. It was so awesome to see him do that.”

Workplaces and their vendor partners can design their care teams to make a larger impact. For example, you can offer hours and services that better meet the needs of your specific employee population. For educators, this might mean providing early morning or afternoon access. For sectors with the highest rates of musculoskeletal issues, like manufacturing, you might add  physical therapy to your health center services.

March is National Nutrition Month, which coincides with a time of year when many are still focused on New Year’s resolutions and have weight loss goals in mind to prepare for summer.

As such, this quarter, we’re seeing a big focus on employers offering nutrition programming. With the rising popularity of GLP-1 medications, as discussed in last quarter’s trends blog, it becomes increasingly important to revisit the basics, like nutrition.

“The use of GLPs for weight loss is relatively new, but the studies conducted so far show a lot more improvement when you combine the medication with nutrition training from a dietitian,” says Marathon Health Registered Dietitian Nicole Boon Lopes. “Once you’re off your GLP-1 drugs, if you did not learn throughout your journey how to nourish your body, then we could be looking into consequences such as yo-yoing, where you go back to your baseline weight, or higher. If we have a disparity between nutrients, we could develop lab values that are not beneficial.”

Exercise, nutrition and mindfulness are key for continued and maintained weight loss. To support those behavior changes, employers can offer webinars, challenges, group programs or one-on-one support from dietitians or health coaches.

“A health coach or RDN (registered dietitian nutritionist) can uncover an employee’s motivation, and also help them use their strengths to develop goals to get to where they want to go,” says Monica McCorkle, Marathon Health Director of Health Coaching and Nutrition Services.

One-on-one meetings with a physician assistant and registered dietitian/health coach helped Marathon Health member Darryl get back on track after uncontrolled diabetes brought him to the emergency room. “We talked about changing my eating habits and taking my medications. I cut out sodas and fast food from my diet and started to eat more vegetables and fruits,” Darryl says. “Taking control of my diabetes relieved the pain in my feet and hands, which helped me feel better so I can take care of my family and work. My health has improved and is the best yet.”

In addition to helping employees live their best lives, offering health coaching and dietitian services affects the bottom line. “Somebody with diabetes that is not managed well is going to cost their health plan usually three to four times the number of somebody without a chronic condition,” McCorkle says.

Wellness program examples include:

• Offering healthy options in the break room vending machines
• Creating a wellness committee within your organization
• Taste and learn demonstrations
• Working with a dietitian to create healthy takeout meals employees can purchase for less than the price of fast food

For National Nutrition Month programming, Boon Lopes taught employees how to use fruits and vegetables that are past their prime to prevent waste. “We work for working people,” Boon Lopes says. “They lead busy lives and maybe don’t think about these things that we as dietitans have been trained to know. So we’re there to remind patients, to keep them accountable, to give them ideas, to lend them a hand to better health through nutrition while taking their medical conditions and medications into account. The sky’s the limit in working with them exactly where they are, and not pushing them, but encouraging them into making certain changes that would benefit their health.”