- Health Maintenance Organization (HMO) enrollment remains very low among Texas employers, at less than 1% in 2013, and participation in Indemnity, Point-of-Service and Exclusive Provider Organizations will drop precipitously and account for less than 6% of total covered lives.
- Preferred Provider Organization (PPO) and CDHPs will absorb the migrating plan members, with CDHPs growing in both numbers and percentage of total enrollees (from 18.5% in 2012 to 24.7% in 2013) as more employers adopt these account-based high deductible plans and encourage enrollment.
- With increasing popularity of CDHPs, employers are focusing on employee engagement, wellness and healthy living as the most effective strategy to improve health and productivity, and control the rate of acceleration of medical costs.
- Drug benefits comprise a significant portion of total medical expenses and many employers actively manage their pharmacy benefits to promote quality and cost-effective therapeutic treatment, most often with a preferred drug list, step therapy and prior authorization for certain drugs. In 2013 almost 20% of surveyed employers will waive deductibles, co-pays and co-insurance to encourage treatment compliance for certain conditions.
- Employers continue to align incentives/penalties with employee participation in health education and wellness programs and are increasingly tying inducements to achievement of targeted health goals and behaviors, and also are expanding eligibility to dependents and non-covered employees.
- Employers are committed to adopting strategic wellness programs to improve the engagement, competence and accountability of individual employees, and plan to supplement print and email communications and on-site health fairs and screenings with less traditional engagement strategies, including 'gamification', incorporating gaming features within wellness strategies to add fun and rewards for successful performance.
- Approximately 70% of survey respondents reported a commitment from senior management and an adequate budget to execute an organization-wide comprehensive health/wellness program 2013; 85% expect to have such support by 2014.
Texas Employer Health Benefits Survey Finds Employers Focused On Engagement, Wellness And Healthy Living Initiatives
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