Category Archives: healthcare

Opioids Continue to Be a Workplace Scourge

158362155We’ve all heard a lot during this presidential election season about the heroin epidemic that has seemingly left no corner of the United States untouched. Experts say an important factor that led to today’s skyrocketing rates of addiction has been the widespread abuse of opioid prescriptions for painkillers, including those prescribed by doctors for employees covered by workers comp claims. A new report from Castlight Health reveals that this prescription abuse continues today, accounting for a significant chunk of healthcare spending.

Castlight’s report, The Opioid Crisis in America’s Workforce, finds that nearly one third (32 percent) of opioid prescriptions subsidized by U.S. employers are being abused by a small number of employees — just 4.5 percent of the population, accounting for 40 percent of opioid prescription spending. Baby boomers are four times as likely to abuse opioids as millennials, the report finds, and workers with a mental health diagnosis are three times more likely to abuse opioids as those without.

The report is based on aggregated reporting from medical and pharmacy-based claims, including de-identified and anonymous health-data reporting covering nearly 1 million Americans who use Castlight’s health-benefits platform. The report defines “opioid abuse” as receiving more than a cumulative 90-day supply of opioids and receiving an opioid prescription from four or more providers over the five-year period between 2011 and 2015.

In addition to the cost (opioid abusers typically cost employers twice as much as non-abusers in medical expenses annually), opioid abuse lowers productivity and potentially puts other employees at risk, says Kristin Torres Mowat, Castlight’s senior vice president of health plan and strategic data operations. Opioid prescription abuse results in more than 16,000 deaths in the United States each year, the report notes.

The report finds that patients living in low-income areas are twice as likely as patients living in high-income areas to abuse prescription painkillers. The South is home to a significant chunk of opioid abusers, with 22 of the top 25 U.S. cities for opioid abuse located in Southern states.

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Using Data to Drive Health Outcomes

Given the hour (8 a.m.) and the setting (the Aria Resort & Casino in Las Vegas), Ronald Leopold, M.D., wasn’t so sure that the time was ideal this morning for a talk centered on getting the most out of employee-healthcare data.

Nevertheless, Leopold—the national practice leader of health outcomes at Willis Towers Watson—soldiered on in the opening session of Human Resource Executive’s Health and Benefits Leadership Conference’s second day, delivering a lively presentation that focused on harnessing healthcare-claims data to better control coverage costs.

In “Doing the Math: Data-Driven Health Outcome Strategies for Employers,” Leopold first asked attendees to rate, by a show of hands, their comfort with data analytics on a scale of 1 to 5, with 1 being the lowest and 5 the highest.

While a scattering of audience members indicated the highest level of comfort with data analytics, and a few ranked themselves as “4s,” the clear majority considered themselves to be “3”s—“not bad, but leaving some room to improve,” noted Leopold.

His goal at that moment, he said, was to help attendees better understand available data “to make the best [benefits] decisions on behalf of their employees.”

In 2016, “we are poised for a new era,” said Leopold, “where we see healthcare costs starting to trend slightly upward.”

For employers, being ready for this uptick entails making efforts to lower employee health risks—implementing effective wellness programs and making plan-design changes that encourage employees to become more responsible for their healthcare, for example—and, in turn, lower healthcare costs.

Leopold urged attendees to “demand the story” beyond typical metrics such as average employee hospital stays and number of employees with a given disease or condition, for instance.

This type of descriptive data “doesn’t always give us a lot,” said Leopold.

“Go deeper, and get diagnostic data to find out why” these numbers are what they are, “and do predictive analysis as well.

“Look at data and use algorithms—which you in HR may not have, but carriers will have, and some consultants will have, and data aggregators will have—to determine [your population’s] health risks,” he continued.

“This,” said Leopold, “is practicing predictive analytics. Then we can see what’s likely to happen in the future … and we’ll get better results.”

 

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Back to the Future for Healthcare

Value-based care. ACOs. Narrow networks. Consumerism. These were just a few of topics explored in depth at last week’s National Business Group on Health’s Business Health Agenda 2016 conference at the J.W. Marriott in Washington. But if there was a single thread running through these sessions and many others during the two-and-a-half-day event, it was the increasingly important role technology is playing these days as a disrupting force.

Consider this: It wasn’t a huge surprise to see the NBGH and Xerox Human Resource Services (the former Buck Consultants) unveil the findings of a study titled Emerging Technology to Promote Employee Wellbeing, one of three research projects released at the event.

Looking at four key areas—gamification, mobile technologies, wearable sensors and social media—the study of 213 employers found significant growth in all four areas, with mobile, not surprisingly, leading the way. When the survey was last conducted three years ago, just 16 percent of employers were using mobile apps to engage employees. In this latest study, that number jumped to 50 percent.

The study also revealed that wearable technologies climbed from 16 percent to 34 percent over the three-year period.

Social networking, meanwhile, grew by 50 percent. “People are increasingly relying on others to get their information,” said Scott Marcotte, client technology leader for Xerox HR Services.

Also, as might be expected, mobile topped the list of future senior-leader priorities, with 50 percent of the respondents citing it as a prime focal point over the next year. Many also predicted that texting will be an increasingly important part of their strategy going forward.

As for barriers to adoption, the respondents cited competing business priorities, the lack of buy-in and support from senior management, the lack of a guaranteed return-on-investment (and ways to measure technology’s impact), and confidentiality and privacy as significant hurdles.

“Technology is also enabling employers to more successfully reach family members,” Marcotte pointed out. He noted that more and more of the companies he’s been working with are “creating hyper-personalized experiences for the spouse,” distinct of the employee.

Of course, you would think the Internet and mobile technology would represent today’s best ways to get educational resources into the home and involve the family, right? But at a session titled Leveraging Technology to Reach the Home, several speakers suggested the next frontier might actually be the television. (Though one conference session on narrow networks featured Back to the Future in its title, I couldn’t help but wonder if that phrase might have been better suited for this one.)

In an effort being led by Kaiser Permanente and Comcast, just out of beta, employees at a handful of employers (Comcast, IBM and Lowe’s Cos.) are beginning to deliver information directly into the home through TV apps.

“People are consuming video on their phones and other devices, but the fact is that many are still watching a lot of TV,” said Chris Stenzel, vice president of business development and innovation at Kaiser Permanente.

Participating with Stenzel on the panel were Marc Siry, vice president of strategic development at Comcast Corp.; Lydia Boyd Campbell, director of global integrated health services at IBM Americas; and Bob Ihrie, senior vice president of compensation and benefits at Lowe’s Cos. (Ihre, by the way, will be participating at two sessions at HRE’s Health & Benefits Leadership Conference later this month.)

All the panelists believe TV has the potential to make healthcare engaging and interesting for the entire family.

Maternity was selected as a pilot for the program because it represents a significant percentage of claims and is a time when families are really engaged in the health system. Videos are delivered to the employees’ TVs based on the stage of the pregnancy—so employees and their spouses/partners are delivered content that’s meaningful to them at that moment. The system knows what to deliver based on the due date, which is the only personal information that needs to be offered up to provide the just-in-time information. (Netflix-like binge watching, however, is still an option for those who prefer that approach.)

Television, of course, isn’t the only legacy device that’s attempting a comeback in the world of healthcare. Let’s not forget the 500-year-old watch, which many are predicting, thanks primarily to the Apple Watch, will someday be a major force in wearables.

That promise isn’t lost on vendors such The Vitality Group, which used the conference as a platform for officially announcing a program that enables “Active Rewards” members to fully fund their Apple Watches by meeting monthly targets over a 24-month period. (The founder and CEO of Vitality Group’s parent company, Discovery Group, Adrian Gore, also delivered the opening-keynote address at the NBGH event.)

Alan Pollard, CEO of The Vitality Group, told me the results of the program in South Africa have been “phenomenal,” with the early data revealing that Vitality members using Apple Watches are more physically active than those using any other fitness devices.

In the United States, early adopters of the new Vital program include Amgen, Lockton and DaVita HealthCare Partners. (The program is also available to consumers through Vitality’s arrangement with John Hancock.)

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Poll: Mindfulness Training Really Works

OK, full disclosure here. A company that provides online mindfulness programs for employers, insurers, wellness companies 166198718 -- meditation2and employee-assistance programs recently announced results of a survey showing mindfulness training improves sleep quality and workplace productivity, and reduces worker stress.

So consider the source, of course. But much like other vendor polls we occasionally report on, this one seems worth sharing. The provider — eMindful, headquartered in Vero Beach, Fla. — analyzed data from 1,200 employees across multiple countries and found a 29-percent reduction in perceived stress among companies offering mindfulness training.

Also, before taking the courses, employees at the responding companies reported losing an estimated 117 minutes of productive time per week. After taking them, that number was reduced to 70 minutes.

Again and mind you, this is one provider’s claim of success, but it does add to the collective wisdom growing rapidly out there that a commitment to workforce-wide mindfulness reaps benefits worth noting, and considering. (This post by me earlier this year features one company’s discoveries along these lines, along with a link to a column by our benefits columnist, Carol Harnett, underscoring the value of workplace mindfulness and the importance of a commitment to it coming from the top and being ingrained into the culture.)

Ruth Q. Wolever, eMindful’s chief scientific officer and associate professor at the Vanderbilt University School of Medicine, says scientific studies on mindfulness “have burgeoned recently, with demonstrated benefits ranging from decreased stress and anxiety to increased immune-system functioning and pain tolerance.”

“The costs of stress for employers include not only absenteeism and losses in productivity,” she says, “but also include medical costs related to unhealthy behavior patterns [such as alcohol or drug abuse, overeating, smoking and sedentary lifestyles as well as] stressful lifestyles that create and/or exacerbate chronic illness [including hypertension, diabetes, obesity, heart disease and stroke].”

Harnett, in her column, corroborates Wolever’s benefits and adds a few more:

“When all is said and done, mind-body programs seem to be at least as effective as lifestyle-management programs and bring benefits such as decreased stress and sleep challenges, and improved cardiac responses to stressful situations.

“Researchers such as RAND Corp.’s Soeren Mattke indicate lifestyle-management programs do not decrease healthcare costs to nearly the same levels as disease-management programs. However, Mattke related on the CoHealth radio show I co-host that employees with chronic health conditions achieve even better results when they participate in both disease- and lifestyle-management initiatives.

“Finally, as Mattke said and I agree, there are other reasons to offer lifestyle-management programs, including mind-body therapies, to your worksite. Mind-body curriculums will most likely please a growing portion of your employee population and improve your workers’ perceptions of the workplace culture. And that may be an employer’s greatest consideration of all.”

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The Cadillac Tax and Large Employers

Employers have held the line on healthcare cost increases for the third year in a row, reports Mercer in its just-released 2015 National Survey of Employer-Sponsored Health Plans. Nonetheless, 23 percent of large employers are at risk of hitting the Affordable Care Act’s widely despised 40 percent excise tax cost threshold in 2018 — and 45 percent are at risk of hitting it in 2022, according to the report.

Per-employee health benefits costs grew by only 3.8 percent this year, marking the third year in a row of a growth trend of below 4 percent, says Mercer. As in previous years, however, large companies fared better than smaller ones in holding the line: Costs rose by 5.9 percent for organizations with 10 to 499 employees, compared to just 2. 9 percent for those with 500 or more.

Large employers were helped by a jump in enrollment for high-deductible consumer-driven plans, says Mercer, while use of these plans among small employers has grown more slowly. At large companies, enrollment has grown from 15 percent to 28 percent of covered employees within the last three years. At small companies, however, it’s risen from 17 percent to just 19 percent.

Total health benefit costs averaged $11,635 per employee this year, Mercer finds, including employer and employee contributions for medical, dental and other health coverage for employees and their dependents. Employers predict their costs will rise by 4.3 percent on average next year, taking into account changes they expect to make to their health plans to reduce costs. They predict costs will rise by 6.3 percent if they make no changes to their plans.

Mercer credits these cost-containment (some would say “cost-shifting”) strategies with lowering the number of plans expected to be hit by the Cadillac tax in 2018. However, the report notes that a plan’s actuarial value is not the only factor that can drive up costs above the excise tax threshold. Health plan costs can vary significantly by geographic region, the degree of competition among providers in a particular market and workforce demographics, it says. Furthermore, it cautions, due to the way the excise tax threshold is indexed, the number of employers vulnerable to the tax will grow every year that medical inflation exceeds the general CPI — thus, by 2022 45 percent of large employers are estimated to be liable for the tax unless they make changes.

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The Next Step for Wearable Tech

Wearable technology has been receiving a lot of attention in the press lately.

ThinkstockPhotos-126914550Just last month, FitBit—by far, the current leading provider in the field of tracking devices—scored a major client win when Target announced it would be giving its 335,000 employees a free Zip, the firm’s clip-on device retailing for around $60. Wall Street apparently was pleased by the news: FitBit’s stock price jumped as much as 22 percent following the announcement.

So I guess it isn’t terribly surprising to see wearable technologies quite visible at this week’s Benefits Forum & Expo in Orlando, Fla. Right?

Just a few steps away from the conference registration desk, FitBit employees were distributing complimentary devices to attendees who agreed to sign up for a charity competition. (Full disclosure: I picked up my first tracker on Wednesday, strapped it on my wrist and joined a team designated “MS Mercenaries,” though I’m clearly not contributing to our tally sitting here writing this post.)

I probably should also mention that FitBit did a similar competition at our Health & Benefits Leadership Conference last year and will be doing it again later this month at our HR Tech Conference.

I also counted at least three sessions dedicated to the wearables topic on the opening day of the Benefits Forum.

One of those sessions, titled “Wearables: A Believable Future or a Passing Fad,” featured David Spierer, president of human physiology at Wellness Science LLC, a New York-based data-intelligence company that focuses on wearable-tech validation.

Spierer shared his insights and perspectives on the phenomenon, including some of the drawbacks employers ought to factor in as they evaluate and implement these devices in their organizations.

Sustainability and accuracy continue to be two major hurdles facing device makers, he said.

According to Spierer, wearables have a life span of about five-and-a-half to six months before the novelty wears off and they end up in a drawer, he said. Either that, he said, or they break.

Still, the appetite for these devices is unarguably huge. Spierer said they’re shipping at a rate of more than 21 million units a year—and some predict that number could rise to 150 million a year by 2018. So people clearly want them!

Spierer also emphasized the need for better validation.

He specifically pointed to manufacturers’ claims that these devices can measure calories, when the only way to accurately measure caloric expenditures is to wear a mask. “Carbon dioxide, oxygen and nitrogen have to all be measured in order to get a true reading of caloric expenditure,” he said. “These devices just do an estimate.”

Yet despite such limitations, Spierer predicted that further innovation lies ahead for the technology and the future is promising.

By integrating the sensors with a complete system, he said, people will be able to do exercises at home and then send that information to their physician.

Spierer also predicted that the devices are going to become increasingly “invisible” and “personalized,” citing companies that have already added them to their clothing and are incorporating them in jewelry such as earrings.

He also expects the technology to get a lot smarter. “They’re going to be context-driven,” he said. “They’re going to know when it’s raining, what holiday it is [and] what your routine is during the day.” And they’re going to start to talk to other devices (for instance, the wearable on your wrist will be able to talk to your phone in your pocket).

“How great would it be if you were walking home with your groceries, the wearable senses your heart rate is going up, the smart lock on your front door opens … and because your sweating, your air conditioning goes on?” he asked.

I’d say pretty great—especially on a day like today, when temperatures in Orlando reached around 90 degrees.

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The Ongoing Expansion of Worksite Health

Affordable Care Act uncertainties be damned—employers are going ahead with their plans to launch on-site health centers.

That seems to be the overarching message to emerge from Mercer’s new targeted survey on worksite clinics.

The New York-based consultancy’s poll is actually a follow-up of sorts to last year’s National Survey of Employer-Sponsored Health Plans, in which 29 percent of organizations with 5,000-plus employees that provide an on-site or near-site clinical site said they offer primary care services. (That figure marks a 5 percent increase in the number of companies saying the same in 2013.)

For this recent survey, all participants from the 2014 poll that reported offering a worksite clinic were invited to answer detailed follow-up questions about their clinic operations. Among the 134 respondents, 91 percent of those with clinics identified controlling total health spend as a “very important” or “important” objective in establishing an on-site center. For 77 percent of survey participants, reducing lost employee productivity was also a key goal, with 68 percent saying they consider improving member access to healthcare important or very important.

These findings are very much in line with what Towers Watson’s 2015 Employer-Sponsored Health Care Centers Survey uncovered earlier this year. In that survey, 75 percent of 105 organizations currently offering employer-sponsored health centers cited increasing productivity as a key goal, with 74 percent indicating the same about reducing healthcare costs, and 66 percent reporting they hope to improve employee access to healthcare services.

What experts at both Towers Watson and Mercer find most interesting about these figures, however, is the suggestion that the ACA’s infamous excise tax hasn’t deterred many employers from building new on-site health clinics, or from expanding existing centers.

“ … Companies are adding centers despite concerns around the Affordable Care Act and its excise tax, which [requires] that the cost of an on-site center has to be included in the cost of delivering healthcare to employees,” Allan Khoury, senior health management consultant at Towers Watson, told HRE in June.

“If that cost goes too high, you violate the Cadillac tax. But we’re still seeing great support for these clinics among employers.”

That’s not to say companies aren’t concerned that on-site health centers’ operational costs could help push them over the threshold for the excise tax, of course. But, by and large, most organizations remain convinced that their clinics “will deliver positive net value,” said David Keyt, principal and National Onsite Clinic Center of Excellence leader at Mercer, in a statement.

In the latest Mercer survey, 15 percent of respondents said they believe their general medical clinic will hurt them in terms of the excise tax calculation, but 11 percent said they think it will help, “presumably by helping to hold down the cost of the company’s health plan,” according to Mercer. Twenty-eight percent think it won’t have an effect either way.

And, ultimately, most companies aren’t really using cost as a barometer for the value of their on-site health centers anyway, according to Keyt.

“For many employers, employee satisfaction is a more important measure of success than ROI,” he said. “If employees are using the clinic, it means they haven’t been taking time off work to visit a doctor, and that they’re getting the medical care they need to stay healthy and productive.”

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Auto Workers’ Push for Pooling

The United Auto Workers is pushing for greater industry consolidation. No, I’m not referring to something along the lines of Fiat Chrysler’s CEO Sergio Marchionne’s on-again, off-again pursuit of merging with General Motors. I’m talking about employee healthcare.

ThinkstockPhotos-101922589A story in today’s Wall Street Journal titled “UAW Pitches Health-Care Co-op to Car Makers”  (subscription site) reports that the “United Auto Workers union is pushing Detroit car makers to put all their employees under one health-care umbrella, creating a powerful purchasing group that could upend traditional health-care markets.” It continues:

“The union’s idea would create a joint purchasing group for the three largest U.S. auto makers that would cover factory and white-collar workers and union-affiliated retirees. The group could total nearly 1 million members, a scale it believes would have unprecedented leverage in negotiating directly with hospitals, drug companies and others.

Assuming the idea even gets off the ground, it could take one to two years to set up and longer to generate significant savings, health-care experts said.”

As the WSJ story reports, “UAW President Dennis Williams previously has described the plan as a way for auto makers to gain more control over health-care expenses and win cost savings. He wants the purchasing group overseen by a board [consisting] of union and auto-industry executives. A prior effort to pull together employees of the three stalled in 2011 because auto makers weren’t interested in pursuing it.”

The UAW is currently negotiating a new four-year deal to replace the current contract, which is set to expire on Sept. 14.

I spoke to Steve Wojcik, vice president of public policy for the National Business Group on Health in Washington, and asked him for his take on the UAW move.

Wojcik says he can’t comment on the union’s plans, since he doesn’t know the specifics, but adds that he certainly understands where the motivation is coming from. Plans, he says, are under a lot of pressure to reduce costs, especially with the ACA excise tax kicking in in 2018.

Still, Wojcik says he isn’t convinced the UAW pooling strategy would be the most effective way to address the cost issue.

“The problem with these efforts,” he says, “is [they involve] voluntary participation—so employers with success at controlling costs or lowering healthcare expenses end up not participating and those having trouble [on these fronts do participate]. Because of this, I don’t think the track record has been that successful.”

Pooling, he adds, has typically found greater success among smaller organizations.

The WSJ story also touches on the practice of direct contracting. “One option for the purchasing pool, say people familiar with the matter, would be for it to establish ‘centers of excellence … ,” the article says. It cites Lowe’s Cos., which has a deal with the Cleveland Clinic and flies employees to Ohio for heart surgeries at no cost to the worker.

Commenting on this, Wojcik notes NBGH’s just-released Large Employer Plan Design Survey reveals that respondents put direct contracting close to the bottom of initiatives having an impact on controlling costs.

Wojcik points out that there’s probably good reason for this. A number of factors need to be in place for direct contracting to work, including the employer needs to have a “significant market power, opportunities need to exist for improving care delivery and there needs to be a decent amount of provider competition.”

“It’s not just about negotiating a discount,” he says.

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Employers and Contraceptive Coverage

In case you missed it, a federal court of appeals ruled last Friday that religiously affiliated nonprofit employers can’t block their employees’ health care coverage for contraceptives.

The ruling in Catholic Health Care System v. Burwell finds that the plaintiffs, which include Catholic health care systems and Catholic high schools, are not burdened by having to formally object to covering contraceptives for employees.

The American Civil Liberties Union  supported the government’s arguments by participating in a friend-of-the-court brief.

The decision by the U.S. Court of Appeals for the Second Circuit held that the religious accommodation in the Affordable Care Act’s contraceptive rule imposed no substantial burden on the plaintiffs’ religious freedom.

The plaintiffs challenged a requirement that employers that object to including contraceptive coverage in their employee’s insurance plans notify their insurers or the government of their objection.  The insurer must then arrange and pay for the contraceptive coverage separately.

“Today’s victory is not only incredibly important for the more than 12,000 employees who stand to gain contraception coverage, but it also sends a clear message that an employer’s religious beliefs can’t be used to deny health care benefits to employees,” said Brigitte Amiri, senior staff attorney for the American Civil Liberties Union’s Reproductive Freedom Project. “We fight hard to protect religious freedom at the ACLU, but that right doesn’t allow employers to discriminate against their female employees.”

With Friday’s decision, the Second Circuit joins six other circuits that have found that the accommodation poses no substantial burden on the nonprofits’ religion, including the D.C., Third, Fifth, Sixth, Seventh, and Tenth Circuits.  No circuit court has ruled the other way.

Viewed purely from an HR perspective, the ruling seems to be yet another small — but welcome — step toward full equality in the workplace.

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The Incredibly Shrinking Carrier Market

It’s official: Anthem announced this morning plans to purchase Cigna for more than $48 billion.

Word Cloud Merger & Acquisitions

Word Cloud Merger & Acquisitions

Coming on the heels of Aetna’s $37 billion proposed deal to acquire Humana, the Anthem-Cigna proposed merger, were it to be given the green light by regulators, would inevitably reshape the health-insurance landscape and provide employers with one less option to consider. But according to experts I spoke to earlier today, deals like the one announced this morning also have the potential of being a boon to employers and employees.

If the Anthem-Cigna transaction goes through, Anthem will have more than $115 billion in pro forma annual revenues, based on the most recent 2015 outlooks publicly reported by both companies. Anthem President and CEO Joseph Swedish would serve as chairman and CEO of the combined company and Cigna’s President and CEO David Cordani would take on the titles of president and COO.

Here’s Swedish’s take on the proposed merger …

“We believe that this transaction will allow us to enhance our competitive position and be better positioned to apply the insights and access of a broad network and dedicated local presence to the health care challenges of the increasingly diverse markets, membership, and communities we serve. The Cigna team has built a set of capabilities that greatly complement our own offerings and the combined company will have a competitive presence across commercial, government, international and specialty segments. These expanded capabilities will enable us to better serve our customers as their health care needs evolve.”

And Cordani’s take …

“The complementary nature of our businesses will allow us to leverage the deep global health care knowledge, local market talent, and expertise of both organizations to ensure that consumers have access to affordable and personalized solutions across diverse life and health stages and position us for sustained success.”

There’s been three national players for a while, with all three of them trying strengthen their portfolios through mergers, explained Tucker Sharp, global chief broking officer at Aon Hewitt in Somerset, N.J. “Someone can put out a headline that says, ‘Five carriers become three.’ But there really have been three national players and what’s happening here is really about building scale … .”

Sharp also noted that lately there’s a bit of merger one-upmanship going on between the carriers and providers. For some time now, he said, the hospitals and physician groups have quietly been merging to get the upper-hand in negotiating with the carriers. Now, much like “an arms race,” you’re seeing the insurer carriers trying to improve their leverage.

At the end of the day, he said, the operational efficiencies and greater scale gained from these mergers could lead to better deals with health providers and benefit employers.

When I asked Sharp if there’s anything HR leaders should be doing differently in light of the Anthem-Cigna news, he said nothing at the moment, noting it’s going to take time for things to work their way through the regulators. If you’re an HR executive, he added, there’s probably nothing you need to worry about for the rest 2015 and 2016.

I also asked Steve Wojcik, vice president of public policy at National Business Group on Health in Washington, for his assessment of the announcement.

His response: “There are some potential upsides and some potential downsides. In the end, we’re looking for some of the cost savings and pricing to trickle down to the employers and employees. But there also are obviously some concerns, because there are only a few players left standing—so employers that want to put their plan administration out to bid are going to have fewer bidders … .”

Wojcik predicts that the Aetna-Humana deal will probably meet less resistance from regulators than the Anthem-Cigna deal because Humana is a smaller player in the employer market, though a much bigger player in the Medicare market.

In evaluating these deals, he said, regulators need to factor in that the health insurance market is dynamic, not static. They’re going to need to weigh into their thinking, he explained, some of the new entities, such as accountable care organizations, that have emerged in recent years and the impact they’re having on the overall market.

 

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