The survey was conducted on 600 U.S.-based HR professionals directly involved in managing their company’s health insurance plan to understand how HR plans to move forward and what support they’re receiving from insurers and plan administrators.

Medical costs are going up, plans are not adapting

Nearly all respondents (94%) of the survey anticipate their company’s medical costs will increase in the following year with a greater amount of claims expected from increased risk areas. Major increased risk areas include decreases in annual physicals/screenings(62%), increased pharmaceutical costs (49%) and unvaccinated employees(47%) among others. HR is considering an array of cost management strategies in order to decrease the expenses but the majority of insurers aren’t offering certain high-impact tactics. Moreover, the survey has revealed that the most effective cost-management strategies are being overlooked. These strategies like out-of-network repricing management, provider network partnerships and quality and cost transparency tools also help in improving personalised healthcare services for members.

The lack of flexibility in the healthcare plan provided by healthcare insurers and plan administrators is pushing HR professionals to switch to other options. 73% of the respondents said their organisation is considering switching its healthcare insurer or plan administrator in 2022. Top reasons behind this decision include a desire for more healthcare plan flexibility (73%), better customer service (65%) and greater support on member engagement (52%). 

Despite HR’s engagement efforts, health benefits are heavily underutilised. More than three-quarters of respondents (78%) say that at least 11-20% of the services their organisation pays for as part of its healthcare plan go unused while 14% of HR decision-makers say that number is 31% or higher.

What are the better options for organisations?

The high percentage of unused plan benefits suggests organisations may be paying for services their member population doesn’t need, aren’t aware of or potentially don’t understand. The survey makes it clear that off-the-shelf plans from traditional carriers don’t provide the customisation or support that employers need from health insurance providers. Maestro Health suggests HR decision-makers to consider opting for self-funded healthcare plans that could better serve their organisation’s needs and combat the rising costs.