The most obvious trends among employer-sponsored medical plans have been well documented: broad cost-shifting to employees, deductibles on the rise, specialty prescription costs skyrocketing.

But beneath this high level of plan characteristics lies another trending level less well quantified. In the 2016 Medical Plan Trends and Observations Report, leadership and technology consulting firm CEB and DirectPath dig deeper into plan characteristics that emerged this year. Along with identifying a more detailed level of plan components, CEB offers its “implications for executives” in which it advises management on the handling of specific plan pieces.

Virtual care: The research discloses a 50 percent gain in the number of companies in the survey that say they are using telemedicine services — one of the largest jumps in any category. More than a third now offer them; by 2018, that will grow to 64 percent.

CEB’s implications for executives: As online patient medical consultations explode, “employers should educate employees on the appropriateness of virtual care for their health care needs. For example, employers should emphasize that virtual consultations are nota substitute for regular visits with a primary care physician.”

Wellness incentives: About half of those surveyed have wellness programs, and they’re ramping up the incentives to promote participation.

Implications: “Wellness programs, when strategic in nature and offered holistically (including emotional, mental, and even financial wellness), can further improve the employers’ operations by increasing employee productivity, engagement, and retention.”

Pregnancy cost: Although the Patient Protection and Affordable Care Act (PPACA) requires employers to offer many free maternity services, not all fall under the Act’s requirements. And employers are raising the employee share of those costs. In fact, the survey found that out-of-pocket expenses for an in-hospital birth were up 35 percent this year.

Implications: “Organizations should be wary of increasing hospital costs too aggressively, as employees are particularly cost-sensitive to them, especially for maternity-related services.” Option: “Offer financial planning and counseling to help employees choose the best plan and save (through health savings accounts) for post-pregnancy services.”

Surcharges: Employers are looking to spousal surcharges to recover some costs, with “41 percent of employers introducing or planning to introduce spousal surcharges and a few even excluding spouses from coverage altogether.”

Implications: “Use of spousal surcharges may merit a closer look as many employers consider eliminating same-sex domestic partner coverage (as it is rolled into spousal coverage).”

Overall advice from CEB and DirectPath to management is that cost-cutting and shifting of costs to employees may be "trendy" in 2016, but top performing companies will want to weigh the benefits of cost management versus the benefits of a workforce that is more engaged. When employees enjoy a healthy benefits package that doesn't nickel and dime them, but allows them to utilize their coverage for better health, they perform better.

Instant Insights /

New report says health plan cost-shifting can go too far

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