Medical Cost Trend: Behind the numbers 2020
PwC Health Research Institute (HRI)
Condensed and presented by Advanced Plan for Health
The Advanced Plan for Health team regularly scans the health market for trends, analysis and insight. In our research, we found The PwC HRI Medical Cost Trend: Behind the Numbers 2020 report to be full of valuable healthcare market information and thought our readers would benefit from the report findings. We decided to condense and present the PwC HRI report in a bi-weekly blog series to highlight what we found to be most pertinent to our readers and to better understand factors that could potentially affect the 2020 medical cost trend. Below is Session #5: The Inflators: Employees and their families will take advantage of greater access to mental health services, per the PwC Health Research Institute (HRI) report.
Session #5: The Inflators: Employees and their families will take advantage of greater access to mental health services.
Historically, employers have considered mental health benefits a lower priority than physical health benefits. This has shifted with the implementation of the Mental Health Parity and Addiction Equity Act of 2008. This law likely is driving increased utilization as access is expanded to comply with the mental health parity requirements.58 Additionally, with initiatives such as the “Make It OK” program to destigmatize mental illness and the National Alliance on Mental Illness’ effort to foster open conversations about mental illness, a growing number of employers are encouraging employees to take care of their mental health.59 These efforts are expected to increase utilization and spending in 2020. Expansion of employer mental health services from 2014 – 2018. (see Figure 9)
Of consumers surveyed by HRI with employer-sponsored coverage, 81% said they had not sought out treatment for a mental health issue in the past five years.61 Eight percent of those consumers believe they should have, but many did not seek care because they thought they could handle their mental health on their own (see Figure 10).62
In a recent HRI survey, 43 percent of respondents covered by an employer said they want their employer to help them manage their mental health and well-being—on par with the share wanting help with physical health and well-being.63 Some employers are taking action by addressing the stigma surrounding mental health, integrating mental health services with primary care and other services, and improving access. Kenilworth, New Jersey-based Merck is piloting a task force at its headquarters that is focused on reducing the stigma around mental health through an eight-hour mental health first aid training for employees who volunteer for the task force.64 The training teaches the volunteers how to identify someone who appears to need help, be a resource to that person and connect them to the appropriate resources.
GE Appliances integrated behavioral health services into primary care at its worksite clinics 18 months ago. Since then, GE Appliances has seen a significant reduction in opioid prescriptions compared to trends in community practices.65
The South San Francisco-based biotechnology company Genentech has placed therapists from its employee assistance program (EAP) in its onsite health clinic.66 Genentech located its EAP within the onsite health clinic to reduce stigma and integrate physical and mental healthcare. Genentech also offers its employees 25 free visits with the EAP therapists per family member each year, in person or virtually.
But finding the right care can be a challenge. “There is a gap between the supply of mental health practitioners who take health insurance and the demand for their services,” said Gregg Nevola, vice president of HR and chief rewards officer at the New York-based health system Northwell Health, in an interview with HRI. Twenty-one percent of consumers surveyed by HRI with employer-based insurance who have sought treatment for a mental or behavioral health issue in the past five years said it was difficult to find a mental health professional accepting new patients for the services they required.67 Northwell Health rolled out an app to 30,000 of its 68,000 employees that allows them to assess their mental health and work to improve it.68 The app identifies low acuity mental health issues and helps the employee deal with them while flagging higher acuity issues to be triaged for immediate care. “The app is one attempt to provide lower acuity care for employees outside of the traditional model so that the limited supply of practitioners can focus on moderate to severe cases,” said Nevola.
With all that is stated in this recap concerning inflators and mental health, each employer needs access to data that will allow them to determine the unique inflators and deflators that are driving their cost trend. In turn this will enable the development of strategies that provide a path to intervene at the point of risk and mitigate its impact, e.g. benefit design considerations, care management effectiveness, and others. To learn more about this research, feel free to contact us here.
PwC HRI Sources
(58) Steve Melek, Daniel Perlman, Stoddard Davenport, Katie Matthews, Michael Mager, “Impact of Mental Health Parity and Addiction Equity Act.”
(59) Make It OK, “What to Say,” accessed May 27, 2019, https://makeitok.org/what-to-say/; National Alliance on Mental Illness, “NAMI Programs”, accessed May 27, 2019, https://www.nami.org/Find-Support/NAMI-Programs.
(61) PwC Health Research Institute consumer survey, spring 2019.
(62) PwC Health Research Institute consumer survey, spring 2019.
(63) PwC Health Research Institute consumer survey, spring 2019.
(64) PwC Health Research Institute interview with Virginia Peddicord, employee population health director at Merck, on April 5, 2019.
(65) PwC Health Research Institute interview with Dr. Diana Han, chief medical officer and global medical director of GE Appliances, on May 9, 2019.
(66) PwC Health Research Institute interview with Anne Marie Tsolinas, senior manager of health and wellness at Genentech, and Emily Fisher Moore, health and wellness principal program manager at Genentech, on May 3, 2019.
(67) PwC Health Research Institute consumer survey, spring 2019.
(68) PwC Health Research Institute interview with Gregg Nevola, vice president of HR and chief rewards officer at Northwell Health, on March 21, 2019.