In recent years employers have been doing all they can to reduce their share of health care costs—from pushing high-deductible health plans to limiting spousal coverage. The big thing for 2015: Companies will increasingly be nudging workers toward cheaper care in different settings, says Dr. Jeffrey Kullgren, an assistant professor at University of Michigan Medical School.
A few examples: Next year 37% of companies will offer telemedicine—consultations with a provider by phone or video—and 34% plan to add it by 2017, according to HR consulting firm Towers Watson. More than half of firms offering health benefits now cover services at retail clinics in supermarkets and pharmacies. Plus, employers are bringing some care in-house: 51% of companies with 200 or more workers offer biometric screenings for diseases, the Kaiser Family Foundation found. Two-thirds of large firms offer lifestyle-management programs to help workers lose weight or quit smoking, and 66% offer disease management, HR consultancy Mercer reports.
This new patient-as-consumer world does have an upside for workers—“You now have an opportunity to shop around for the most affordable care,” says Kullgren.
Here's what you need to know for 2015.
Get wellness at work. A 2013 survey from the Department of Labor and Rand found that few people take advantage of employer wellness initiatives: Fewer than half of eligible workers took part in clinical screenings, 16% made use of disease management, and only 10% joined weight-management programs. The rest are missing out on big savings. The Affordable Care Act allows employers to offer up to a 30% reduction in health-insurance premiums for participation in wellness programs, notes Jacksonville financial planner and MD Carolyn McClanahan.
And there’s more at stake than premiums: Flu shots—which many firms offer for free—result in a 71% reduction in related hospitalizations among adults, per the CDC. Weight loss that takes you out of the obesity zone can save you $2,800 a year, according to a National Bureau of Economic Research paper. Screenings can identify risk factors for illnesses like diabetes—and that disease can increase medical costs by a factor of 2.3, the CDC reports.
Make the right call. On average, the out-of-pocket cost for telemedicine is around $40, vs. $95 for a regular doc visit, Towers Watson reports. Despite the savings, it isn’t right for every health issue. Andrew Fitch of NerdWallet Health says that telemedicine is best used when you need monitoring for a condition you’ve already been treated for or for concerns that likely wouldn’t require in-person testing—e.g., “What’s this weird rash?”
Get care where you get groceries. The Kaiser Family Foundation found that among employers that cover retail clinics, 14% provide a financial incentive to get care at one over a regular doctor’s office. A retail clinic is a viable option—medically and financially—if you need, say, a vaccine or treatment for a minor illness like a fever or sore throat, says Fitch.
Just don’t let this and other new care options tempt you to skip out on regular physicals with your regular doctor (which your insurer likely covers 100%). Most important, Kullgren says, keep your GP in the loop about other care you get.