Q2 2023 Employer Healthcare Trends: Preventive Care, High-Quality Referrals and Affordable Prescriptions

Faced with ever-increasing costs and unhealthy workers, health-conscious employers continue to lead the way with innovative strategies to disrupt the status quo.

From encouraging preventive care and offering dedicated pharmacies to connecting employees with high-quality referrals, read on to learn about some of the latest employer healthcare trends.

Today, nearly one-third of all organizations with at least 5,000 employees provide a dedicated health center to their employees. The health centers offer primary care, chronic condition management, behavioral health support and wellness services at little to no cost. Rather than taking a reactionary approach, the employer-sponsored model prioritizes prevention.

According to Marathon Health data, employees are more likely to be proactive in taking care of their health when offered dedicated care through their employer. In fact, 65% of Marathon Health member visits in 2022 were for preventive care.

“There’s the saying ‘an ounce of prevention is worth a pound of cure,’ and it really is true,” says Dr. Michael Huang, a physician and health center director at Marathon Health. “If you really address a patient’s preventive health measures and you prevent disease from occurring before it starts, it ends up creating a much healthier population and saving money down the road.”

Employers often incentivize employees to take preventive measures, such as getting an annual physical and biometric screening, to give employees a snapshot of their current health and to encourage them to establish a relationship with their health center care team.

“They often come in because they’re going to save money, but then they realize that we have more time to talk to them, we spend more time discussing their preventive care,” Dr. Huang says. “The goal is to help every patient feel more responsible for their own health and want to make changes to become healthier.”

A basic lab draw and physical exam can detect several of the leading causes of preventable death, such as heart disease, diabetes and various cancers.

“If we can prevent heart disease before it starts, that’s a very big deal,” Dr. Huang says. “Regular blood pressure checks, cholesterol screenings and different preventive measures are very important to catching serious problems early. We also screen for several types of cancer, such as breast cancer and cervical cancer for women and prostate cancer for men.”

If a preventive screening uncovers a chronic health issue, the health center care team works with the employee to establish a personalized plan to address their concerns moving forward. In 2022, 59% of Marathon Health members with high-risk conditions made measurable improvements on their health.

“We’re empowering members to make their own good decisions and help them understand what they need to do and the benefits of doing it,” Dr. Huang says. “The days of the doctor spending no time with the patient and just writing a prescription are long gone — at least in our model. It’s much more of a partnership now, and I think helping patients take control of their own health is a big part of living happier, healthier lives.”

Even with access to health services, patients often need a referral to outside specialists. Yet, in the traditional healthcare market, studies show 65% of patients do not “close the referral loop” from their doctors. The patients who do follow through on referrals are usually steered toward in-network providers who may not provide the best care or the best cost.

“Traditional health system doctors are incentivized and almost required to refer care inside their system, even if the best provider isn’t there,” says a Vice President and Partner at an employee benefits consulting firm. “Oftentimes, the employer ends up paying to send people to providers who might not be the best or who might not produce the best outcome.”

As an independent provider with no ties to major health systems, Marathon Health’s referral team provides members with options based on price, quality and convenience, and leverages Garner Health’s data-driven physician analytics — a proprietary model that uses 500+ specialty-specific measures to assess a specialist’s impact on total cost of care.

“There are two ingredients we think are really important to quality referrals. One, is being able to invest the time, attention and human connection in helping people make the right choice around their referral and complete the referral,” says Pierce Graham-Jones, Chief Strategy Officer at Marathon Health. “Second, we empower our referral coordinators with the best possible cost and quality data from Garner to help the patient make the right choice.”

Whenever a member needs a referral, a Marathon Health referral coordinator reaches out within 24 hours to make contact and present a range of options. “Our coordinators literally call the member up and say, ‘I’m going to help you select a provider. I’m going to schedule the appointment for you and hold your hand all the way through the process,’” Graham-Jones says.

According to the most recent data, 73% of members in need of a procedure chose the referred provider from Marathon Health, at a prospective estimated savings of $245 per procedure.

“We run claims analysis for procedures like an MRI, colonoscopy or imaging, and we’re saving a significant amount of money based on Marathon Health referrals versus members who seek care outside our recommendations,” Graham-Jones says.

Not surprisingly, Marathon Health members like the concierge approach, giving it an impressive Net Promoter Score of 90.

A recent study found 60% of adults take at least one prescription medication, while 25% take four or more. With prescription costs rising year after year, employers often take matters into their own hands and provide prescriptions directly through their health center partner.

To date, 80% of Marathon Health clients offer a dedicated pharmacy solution, via onsite and Network health centers or through home delivery. The employer-sponsored pharmacies provide convenient access to hundreds of common medications for everything from the common cold to high blood pressure, thyroid issues, diabetes, asthma, allergies and more.

“We’re like a one-stop shop,” says Abby Kolls, Manager of Vendor Relationships and Procurement at Marathon Health. “If a member comes in for an appointment, whether it’s for a chronic condition or for an acute sick visit, they can pick up their medications before they leave — at little to no cost.”

Here’s how it works: The health center provider pre-purchases medications from the supplier at a highly discounted rate — up to a 91% discount on the average wholesale price — and passes the savings on to the employer. The fees are significantly lower than obtaining medications through a traditional health plan.

Kolls says Marathon Health always advises employers to make medications available at little to no cost. And not just because employees save money, they’re also more likely to follow through on taking their medications. “If I have a chronic condition like high blood pressure or diabetes, I’m going to be more compliant if I can get my medications for free, either at the appointment or via home delivery, and don’t have to make a trip to the pharmacy,” Kolls says. “And I’m less likely to miss days because I wasn’t able to go to the pharmacy and refill it.”

Ultimately, Kolls says employer pharmacy solutions enhance convenience and compliance while also reducing costs. “Ideally, you should see a cost reduction at multiple levels, because your medication costs go down, and then your health plan costs should go down too because your employees get the routine healthcare they need.”