This year marked our fourth annual Deep Dive Roundtable where leading employers from across Ohio gathered in Columbus to discuss plan management strategies and review benchmarking information on how their plan metrics stacked up against peers’. The fourth iteration of the gathering also featured two special guests who added fresh layers of insight and perspective to the day.
We heard from John O’Brien, HHS’s Senior Advisor to the Secretary for Drug Pricing Reform via live videoconference from Washington, DC. John discussed the Administration’s blueprint to lower drug prices and reduce out-of-pocket costs. While much of the current focus has been on Medicare, he emphasized that they are working to help employers facing very similar challenges posed by PBMs and drug manufacturers.
We were also thrilled to have Tony Hawk, Sr. VP of Human Resources from Pace Industries, join us in person as a plan sponsor representative and guest speaker. Tony shared his first-hand experience with Edison Healthcare, a centers of excellence program he implemented after an extensive evidence-based analysis to ensure employees and their families were getting the best care for the best price.
Prior to the event, participants submitted data on a number of important health plan measures, which we then compiled, analyzed, summarized, and presented back to them. In case you missed it, some of the key takeaways included:
- The prescription drug data showed that direct rebate arrangements (i.e., not reinvested) may be contributing to a lower spend.Either way, plan sponsors should explore all options available to find the best arrangement to suit their needs.
- It’s no surprise that specialty drug spend continues to grow, making it a prime area to target for tighter management. We found this to be true for all companies, regardless of size and scale.
- The medical data showed that buying medical TPA services based on network match and discounts does not necessarily lead to lower costs. When we looked at costs and network performance by various networks, no clear winner emerged. (Interest in learning more on this topic? Check out our recent article.)
- Consumer driven health plans have not been the silver bullet everyone hoped for in managing plan spend. Anecdotally, we also heard in our breakout discussions that employers feel cost shifting via HDHPs has been exhausted at this point.
- Managing inflationary trend is crucial — especially with the looming “Cadillac” tax.The better trend can be managed over the next few years, the better off employers will be if that excise tax on high cost health plans hits in 2022.
- Dependent ratio and age appear to be more influential on cost than network performance and HDHP enrollment. The age correlation surprised us this year, as it has not been strongly correlated with costs in past data sets.
Lastly, we learned that Nicolas Cage has been in an incredible number of films. Don’t get the reference? Guess you’ll have to join us next year for a day of learning, sharing, and top-notch humor!