Employers and Today's Health Care Marketplace: Between a Rock and a Hard Place?
March 16, 2012
Employers provide health insurance to over 160 million Americans, giving them a considerable stake in the costs of health care. Yet after over two decades of efforts by large employers to both tame costs and improve the quality and value of care delivered to their employees, the costs of providing health benefits continue to rise at rates exceeding the growth in wages. This has occurred despite the expectation that large employers would be able to leverage their purchasing power—at least in some markets. Of course, many large employers continue to support initiatives to contain costs, such as value-based benefit design and disease management or health promotion programs, and to steer employees to more efficient providers through the use of tiered networks and centers of excellence. The primary cost-containment tool today, however, appears to be shifting more of the costs to employees through increased premiums, deductibles, and cost sharing. Moreover, while many employers say they will continue to offer health insurance to remain competitive in the labor market, the prospect of employees eventually being able to purchase policies through an exchange raises questions about the future of employer-sponsored insurance.
Given the changes in the organization and delivery of health care that have occurred over the past two decades, what role can employers play in controlling costs and obtaining greater value for the money they and their employees spend? Can employers leverage their purchasing power in markets where providers have consolidated? Where insurers have consolidated? Are there new approaches on the horizon that will be more successful in taming costs? Are employers in it for the long haul, or will some get out of the business of providing health insurance if the circumstances are right?
To explore these and related questions, Robert Galvin, MD, chief executive officer of Equity Healthcare, The Blackstone Group joined us for a small-group discussion. Prior to joining Blackstone in 2010, Dr. Galvin was executive director of Health Services and chief medical officer for General Electric.