The healthcare industry is transforming as technology drives virtual care and medical advances, healthcare accessibility goes retail, and generational behaviors change. Employers are challenged to keep healthcare programs affordable and relevant. - BY MALIBU KOTHARI

From virtual care to new technologies to healthcare going retail to medical breakthroughs to changing employee expectations, employers struggle to design healthcare programs that remain relevant and flexible while keeping them affordable. Relevant means employees experience the most significant impact on their health. Flexible means the program meets the needs of a modern and diverse workforce. Affordable is two-sided, referring to employee and employer costs. Healthcare programs must be value-based on many levels, beginning with determining what employees want and expect.

Recognizing the Transformational Factors and Must-Haves for the Future

So much is changing in the healthcare industry. Virtual healthcare usage continues to grow, so employers need insurance companies willing to pay for this kind of service. More medical services are delivered in outpatient clinics than hospitals. Healthcare tools are linking the Internet, portable technologies, and digital wearable devices in new ways. Big data and AI generate insights and predictive analytics, but knowing how to use those analytics for informed decision-making requires knowledgeable business leaders.

There are more changes as healthcare moves towards fewer hospitals and more freestanding clinics and urgent care. Healthcare is also moving towards becoming “retail-ized.” For example, CVS Health offers walk-in clinics that are less expensive and faster than an urgent care visit. CVS says walk-in clinics can save 40% over the cost of urgent care services. Employers can negotiate with insurance companies to ensure these services are covered and encourage employees to use the clinics when appropriate.

Telehealth is also reshaping healthcare service delivery. As workforce demographics change to include more members of younger generations, employers are finding their employees expect to access virtual self-care and advanced healthcare options through websites and apps. Extending the concept of virtual healthcare to virtual wellness, employer healthcare programs can add access to virtual wellness opportunities to their health and wellness programs. For example, offering virtual exercise classes or dietician consulting can promote wellness while giving employees the personalized experiences they expect today.

As employers rethink their health and wellness programs, they must consider the new service delivery options, technologies, and employee expectations. Holistic programs that fulfilled employee needs just a few years ago may quickly become outdated. Millennials and Gen Z, in particular, want personalized 24/7, technology-enabled health and wellness benefits.

Adapting Strategies to the Times

The American Hospital Association named three healthcare areas that employers are focusing on in 2024. These include mental health, preventative medicine, and care coordination. For 2024, the first goal is increasing mental health services for anxiety, depression, and substance abuse disorders. Employer healthcare programs should include mental health services as employees struggle with society’s complexity.

A second trend is a focus on preventive medicine. The pandemic led to many people delaying their screenings for cancer. The AHA found that 41% of employers anticipate an increase in late-stage cancer in their workforce for this reason, and cancer care is the primary driver of healthcare costs. Including 100% (or close to 100%) insurance coverage for screening services will encourage employees to participate in preventive medicine. In addition, employers are staying informed on medical advances like immunotherapies and biomarker testing. These are costly healthcare services, so this is a two-pronged issue requiring balance. One is that covering these treatments can improve outcomes. However, these medical advances can drive healthcare costs up compared to the cost of more traditional care services. The third employer trend the AHA describes concerns about the outcomes, quality, and cost of virtual healthcare when there is a lack of coordination between the virtual solutions. As new vendors continue to enter the marketplace, employees may not get the best health and wellness care when they choose to use disparate and multiple options. This directly affects outcomes and benefits program costs.

Encouraging Wellness

The issues mentioned are complex, and solutions are not always readily apparent because the health and wellness industry is constantly in flux. However, employers should not overlook straightforward opportunities to promote health and wellness that also improve employee engagement. Not everything has to embrace technology.

For example, encouraging employees to exercise during the workday applies to in-office, hybrid, and remote employees. Exercise may include a walk around the office building or the block around the home. Offering opportunities to take advantage of discounts on healthy food options, gyms, or wellness classes or to attend injury prevention programs can increase employee engagement in taking charge of personal well-being. How does an employer maintain a relevant health and wellness benefits program in the face of so many changes in the healthcare industry? One strategy is regularly engaging with employees to understand their needs and preferences better. This can be done through surveys, focus groups, or feedback sessions. Effective communication is also vital in ensuring employees understand and engage with healthcare programs. Organizations should develop clear and concise communication strategies to educate employees about available benefits, how to access them, and any program changes or updates. To reach employees, employers must use multiple channels such as emails, newsletters, intranet portals, social media, and in-person meetings. It is also essential to develop a communication strategy that ensures that the information delivered across the communication channels is always consistent.

Stay Flexible and Adaptive

Regular assessment of programs and data-driven decision-making are at the core of keeping the health and wellness programs relevant. Organizations should regularly assess their healthcare programs to identify areas for improvement. This includes staying informed about medical advances and changes in the vendor landscape, such as new treatment options or emerging technologies.

By staying flexible and adaptive, organizations can incorporate new developments into their healthcare offerings to better meet the needs of employees. Data analytics can identify trends and patterns in employee utilization of various program elements. Underutilized benefits have not been effectively communicated or do not meet employee needs. As the health and wellness industry continually changes, so must employer benefits plans. The days of offering inflexible programs are gone.