This past year was a year of seismic shifts that saw tech giants— including Amazon and Google—coming to the table to find their place in a changing American health care system; the merger of retailers and insurers like CVS and Aetna; and an accelerating growth rate in worksite health centers.

The trend might be summed up as such: the private sector is taking health care by the reins. And, at an increasing pace, we saw U.S. employers explore different methods of providing quality care for their employees, without breaking the bank.

As we've watched employers continue to rise to the occasion, it has become increasingly clear that these stakeholders are the gatekeepers to transforming the health care system—making this far more than a passing trend.

As this momentum continues, 2019 will surely be an interesting year of change for employers, employees, and the health care industry as a whole:

Getting in front of high-cost claims

Self-funding for health care benefits comes with risks and benefits. The benefits include program control, flexibility in plan design, and more predictability in costs. The risks are in the high cost claims, specifically from cancers and musculoskeletal conditions. Costs related to musculoskeletal disorders skyrocketed by 131 percent from 1996 to 2014, and total spending on cancer treatment is expected to increase 27-36 percent in the next decade.

In order to address these trends, employers must get ahead of the curve before the conditions escalate. The tools available to keep cancer and MSDs at bay are prevention, detection, and on-going support. Unfortunately, we still have a ways to go until medical cures are identified for these conditions, but until then, identifying risk factors early on, encouraging employees to make lifestyle changes, and offering individual, peer and group programs will be the best way for employers to enable the longevity of their workforce without breaking the bank.

Keeping mental health in mind

Considering mental and behavioral health care will become central to many employers' benefits strategies in the New Year, and with good reason—each year, more than 70 million working days are lost due to mental health, costing employers more than $276 billion. As mental health conditions like anxiety, depression, and chronic stress become more and more prevalent, increasing access to mental health services will only be the starting point.

Employers who truly want to improve their employees' health outcomes and boost productivity will make mental health a core part of their culture, addressing the stigma of mental health conditions, and begin offering onsite mental health counseling for those who need it.

Onsite health care: A benefits staple, not a perk

In 2018, Apple announced “AC,” its onsite health clinic and made waves with this approach to fixing a broken health care system. We welcome them to the movement to help employers have healthier, more productive employees while addressing the ever-rising cost of care. Onsite (worksite) health centers have been operating for more than a decade at employer organizations committed to delivering a better, more effective patient experience, supported by technology and longer appointment times to address patient needs. These are the principles that are central to our work at Marathon Health, and the net result of this is improved health and lower cost of care for employers and their employees.

It will be interesting to see if companies like Apple base their onsite health care models on population health—a method that has been proven effective—or take more of a luxury approach. Regardless, these moves show that employers will remain committed to improving health and lowering the cost of care for their employees.

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Dr. Michael Huang, MD, is national medical director for Marathon Health. Dr. Huang has more than 20 years of experience in primary care. He joined Marathon Health in 2013 as the medical director of the Lexmark Health and Wellness Center prior to transferring to the Samuel Brown Health Center for LFUCG employees and families in 2017.

Instant Insights /

2019 predictions: Employers will be key to transforming health care

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