We believe employers who know their numbers make better plan decisions. We also believe there is value in employers talking to each other about their respective challenges and solutions.
These are the fundamental principles behind our annual “Deep Dive” Roundtable in Columbus. It’s a simple concept really — as plan managers, it’s important to understand what’s driving costs. But tracking and analyzing health plan performance data can occasionally get lost in the recurring waves of vendor implementations and renewals, wellness events, open enrollment, HRIS system changes, or whatever else is the benefits priority of the quarter.
For the third straight year, Roundtable members from Akron, Cincinnati, Cleveland, Columbus, Dayton, and Pittsburgh came together to compare and discuss data for a combined half million lives and $2.5 billion in annual medical and prescription drug spend. The day focused primarily on sharing employer strategies and initiatives to contain costs, and also included an insightful session on Emerging Therapies and Specialty Drugs featuring our consulting pharmacist, Kelly Prymicz.
The medical data brought forth some interesting results. Notably, that an employer’s member ratio and cost share have a much stronger correlation with per employee costs than age and high deductible health plan enrollment.
For prescription drugs, we learned that 72% of employers were receiving their rebates via check. And of those, PEPY costs were about $400 higher than for employers having them reinvested (into discounts). We also learned that specialty drugs continue as the primary driver of plan trend — with Kelly shedding light on new-to-market drugs costing individual plans $1 million and more a year.
Roundtable members discussed several strategies they’re deploying to manage costs in these areas, including copay assistance programs, spousal surcharges or carve-outs, and managing site-of-care opportunities for certain procedures.
According to attendees, it was definitely a productive day of learning and sharing (100% of survey respondents said it was time well-spent). For those of you that missed the event, we hope you can join us next year. In the meantime, we look forward to everyone’s continued participation in the local Roundtables!