Health Care & Benefits

The CAA transparency requirements have created new opportunities to assess and compare the cost of care between health systems and other medical providers, but the compliance requirements can feel burdensome to employers. NFP partners with medical and pharmacy vendors to gather all required data and manages the timely submission of any new government reporting requirements for our employers.

While the compliance requirements have been challenging to navigate, the potential of this data is encouraging. The CAA and related Transparency in Coverage regulations require the posting of publicly available machine-readable files containing actual costs paid by group health plans. The availability of this data across all group health plans is a game changer in terms of identifying the most cost-effective sites of medical care. And more advanced vendors in this area are also including quality scores across systems, so a plan sponsor can drill down to both cost and quality metrics.

While many employers are taking a wait-and-see approach, a notable number added coverage for these medications for weight-loss purposes (similar medications were already covered for diabetes) and worked with their pharmacy benefit manager to put in place appropriate prior authorization. We are encouraging employers with lower-than-average turnover to take a long view and consider the potential savings generated if sustained weight loss reduces future claims for cardiac, orthopedic, and other conditions and reduces complications from diabetes. Sustained weight loss could also boost overall productivity.

Finally, yes. While on the East and West coasts more narrow high-performance networks have been the standard, we are starting to see demand in the Midwest from employers. NFP’s TPNet tool provides a strong tool that provides transparency of both cost and quality. With that powerful information, plan sponsors can make informed, confident decisions.

State-based paid leave regulations create a challenge for multi-state employers, particularly because this area is quickly evolving, with new legislation being considered by state legislative bodies every year. Many employers rely on their HRIS partner to manage the different state requirements, particularly as those relate to unique withholding rules and payments into a state-run system. The added complexities of ever-changing leave legislation across the country have caused many clients to reevaluate their current strategy and consider new tracking tools, or even outsource leave administration altogether. Employers are also relying more heavily on benefits and HR consultants to keep them apprised of the evolving requirements.

It can be difficult to navigate the healthcare system on your own or through an employer-paid health plan. But frequent and easily accessible information about the group health plan’s network will drive improved understanding of how to best access in-network providers. Continuing to expose employees to carrier-provided resources will also support navigation of the plan. New platforms, like Rightway and HealthJoy, are now available to take the guesswork out of finding the right care based on quality and cost. Employers can invest in these tools to improve the experience of employees while driving better financial outcomes.

Employers are adding a wider breadth of targeted solutions to support employees wherever they are and in experiences they are facing in every phase of life. As employers seek to navigate the hybrid work environment, thoughtful communications strategy must be at the forefront of the benefits rollout. Decision support tools, educational microsites, and care navigation tools have all aided in showing the value of increasingly robust benefits offerings.

Here are a few key things NFP’s Employee Communications practice recommends to all clients.

1. Make communication constant. Having a robust open enrollment campaign is important, but it can’t stop there if you want to improve population health.

2. Multi-channel campaigns have never been more important. Make use of online, mobile, SMS, mail, print on-site, email, middle management talking points, etc.

3. Partner with your friends in marketing to leverage their writing and design prowess. You need their talent and might end up creating some health plan ambassadors in the process.

In a more competitive candidate market, where skilled professionals have abundant options, pay transparency becomes a powerful tool for attracting top talent. By openly communicating pay ranges, healthcare organizations signal their commitment to fairness and equity, which can enhance their appeal to prospective employees.

Candidates also expect a clear explanation of how pay is determined. Healthcare employers should articulate their compensation strategies, including factors like experience, qualifications, and market benchmarks. This ensures transparency and builds trust with current and potential staff. Don’t forget to disclose the full range of benefits, including healthcare benefits, retirement plans, professional development opportunities, and work-life balance initiatives. By transparently presenting the holistic value of the total rewards package, healthcare employers can differentiate themselves in a competitive hiring environment.