Gating ranks high among the strategies employers are considering when they ponder health plan design in the next three to five years.
That’s one of the findings of an Aon Hewitt survey of more than 1,000 employers. Respondents were asked to disclose current plan design elements, and then to project changes in plan design they envision making three to five years out. Gating — the offering of different levels of health insurance coverage tied to completion of, for instance, a health assessment — turned out to be an option that has caught the eye of many employers.
More than half of those interviewed said their plans today included what would be described as traditional cost mitigation elements, such as shifting costs to employees. But only one in five believe they will still be relying on such strategies in a few years. And while just 20 percent include gating insurance options today, “more than 60 percent of employers plan to gate employees to richer designs, where employees are required to complete a 'task' to access richer design options,” Aon Hewitt said.
“Gating strategies are becoming an increasingly attractive incentive technique among employers as they look to improve the health of their employee populations,” said Jim Winkler, chief innovation officer of health & benefits at Aon Hewitt. “For example, employers may offer a basic high-deductible plan to their entire workforce, but make a richer PPO option available to those employees who complete a health risk questionnaire or biometric screening.”
Other findings from the study, which has not yet been released in its entirety, include:
- 72 percent of employers are, or will be, reducing subsidies for dependents;
- 68 percent of employers plan to adopt reference-based pricing — where employers set a pricing cap on benefits for certain medical services for which wide cost variation exists with no discernible differentiation in quality —up from 10 percent today;
- 52 percent of employers anticipate using unitized pricing — where employees pay per person and not individual versus family — up from 5 percent today;
- 42 percent of employers are considering offering high-deductible health plans as a full replacement plan, up from 15 percent today;
- 24 percent of employers plan to offer employees tools to guide decisions in plan selection and utilization, up from 19 percent today;
- 92 percent plan to offer cost transparency tools, up from 49 percent today.
“Employers are increasingly realizing that traditional approaches to mitigate health care cost trend need to be advanced,” said Tim Nimmer, chief health actuary for Aon Hewitt. “Over time, plan design strategies will evolve to be more requiring of employees, and individuals will be held more accountable for their health and for using health care. At the same time, we see that employers are increasingly committed to providing employees with decision support tools that provide greater transparency around the cost and quality of care, so that individuals can make more informed health decisions for them and their families.”
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