Concerned about the disappointingly low levels of COVID vaccinations in the U.S., the Northeast Business Group on Health (NEBGH) has stepped into the fray to help plan sponsors tackle the issue with their members.
“Creating a Vaccination-Friendly Culture: What Employers Can Do,” is intended to serve as a guide to develop and implement strategies to boost vaccination rates for seven medical conditions, including COVID, in employee populations, and hopefully, their families and significant others.
“The public’s mixed response to COVID-19 vaccines has highlighted the urgent need to create a more vaccination-friendly culture if we are to reap the benefits of scientific advances in fighting disease and illness in the future,” says Candice Sherman, CEO, NEBGH. “The data shows that employers are a trusted source of information and therefore in a unique position to fight misinformation, promote vaccination as an essential part of overall wellness and set an example by communicating their commitment to vaccination.”
In compiling its 40-page guide, NEBGH surveyed 103 large employers about their vaccination policies. The big picture: 85% don’t set targets for employees to be vaccinated, and 75% cite misinformation and vaccine hesitancy as barriers to boosting vaccination rates among their employees.
Other survey results:
71% of employers say they host vaccinations campaigns.
83% say they have launched vaccination communications campaigns for employees. (Far fewer have included family members or retirees in these campaigns.)
75% have reduced or eliminated out-of-pocket costs for vaccines.
33% offer vaccination incentives.
50% provide paid time off for vaccinations.
3% offer transportation for vaccinations.
To give plan sponsors and advisors a better understanding of the subject, the association’s guide includes information on vaccination history; data on uptake; racial and ethnic disparities in vaccination status and barriers to vaccination; and more.
Here are the eight steps offered by the guide to raise the vaccination rate among plan members. The guide discusses each step in detail:
“The critical focus over the past two years has been on vaccinations to fight COVID-19, but employers recognize that vaccinations against other diseases and illnesses can play a significant role in improving the overall health and wellbeing of their employees, families and beyond. And it starts with creating a vaccination-friendly culture. We are hopeful that employers will take specific actions described in the guide and work hard to boost vaccination rates in the coming years,” says Sherman.
Although health care costs are increasing, Mercer found that most employers do not plan to shift costs to their employees by raising deductibles or co-payments.
In fact, many employers are planning to expand their health benefit options in 2023, focusing on improving affordability and access. According to a July survey of 700 employers from Mercer, more than two-thirds said they planned to enhance their health and benefit offerings next year, and 61% are currently surveying employees on their benefit preferences.
Some benefits that employers are considering adding include mental health benefits, such as meditation apps and substance use treatment, and family planning benefits, such as in vitro fertilization treatment. According to Modern Healthcare, data suggests that these benefits, among others, are highly important to younger employees.
Outside of providing more benefits, some employers are working to better communicate with employees about the benefits already offered.
According to Candice Sherman, CEO of the Northeast Business Group on Health, many employees at the group's member companies do not understand the full scope of their benefit plans.
"Many of our members talk about employees saying they've got this issue, and they're surprised to learn they have benefits for that," Sherman said. "Members are focused on how to communicate and promote benefits."
In addition, Sherman said she believes businesses will focus on providing more "wraparound, holistic" benefits in the future, including more family-building resources, financial wellness, child care, gym memberships, and even pet care.
The Northeast Business Group on Health launched a new tool Thursday to help employers determine if their company provides adequate mental wellness support to their staff.
The survey tool, called Well Gauge, asks participants a series of questions through four sections: communicate a commitment to mental health, engage leadership at all levels, demonstrate a commitment to mental health equity and foster environments that support total health.
Northeast Business Group on Health’s tool comes as more employers are looking to bulk up their mental health support for employees. A recent Willis Towers Watson survey of 455 employers found that 67% are looking to make mental health and emotional wellbeing programs a top priority in the next three years. It also found that 88% of respondents have already acted on mental health in the last year, with some of their top strategies including covering telebehavioral health services, providing employee assistance programs and giving access to digital behavioral health support.
But while mental health benefits and programs are necessary, companies need to do more for their employees, Tippett-Stangler said.
“Providing benefits coverage and offering programs for mental health are essential — but not sufficient — to support employee well-being,” Tippett-Stangler stated. “Creating inclusive environments in which mental health is a priority, mental illness is de-stigmatized, and employees feel valued as whole people is central to building a healthy, productive and committed workforce.”
The cost of providing health insurance in New York in the last year is higher than the national average and could continue to rise because of worsening inflation and increasing premium rates.
A new health benefits report from the Kaiser Family Foundation that surveyed more than 2,000 employers shows that in 2022 the national average annual premium for family health insurance was $22,463, about a 1% increase from the $22,221 average reported in 2021. In the Northeast, the average cost for covering a family was $24,126, about a 2% increase from 2021.
Nationally, employers paid just under $21,000 for point-of-service plans; just over $21,000 for high-deductible health plans; nearly $23,500 for preferred provider organization plans and almost $23,000 for health maintenance organization plans. By comparison in the Northeast, those figures were all higher: employers paid nearly $22,000 for POS plans; about $23,000 for HDHP plans; just over $24,000 for PPO plans and more than $28,000 for HMO plans, which experts say can be attributed to increasing premium rates and the rising costs of health care, which are climbing more steeply in New York and New Jersey than the rest of the country.
Leslie Moran, the senior vice president at the New York Health Plan Association, pointed to insurers asking for higher rate increases within the last few years, and continuing to do so for 2023, as another indication that New York is bucking national trends.
The state Department of Financial Services, which approves insurance plans’ requests for rate increases each year, or how much the cost of paying for certain types of coverage will change reports that in 2022, insurance firms that are part of the individual market requested to increase their rates by more than 11%; companies in the small group market requested to increase their rates by 14%.
For 2023, companies requested to increase premiums by nearly 10% for insurers on the individual market and almost 8% in the small group market.
The prices New York consumers pay for their health care are already high, Moran has said, because state law requires that more than 3,000 procedures be covered by insurers, such as second opinions for cancer patients. High costs–for the employer or employee–can lead to concerns around care accessibility.
Inflation compounds the issue of rising health care and health insurance costs. The premium growth rates Kaiser collected from employers have kept pace with inflation and wage increases over the last five years, according to Matthew Rae, the associate director for the program on the health care marketplace at KFF and an author of the study. But "keeping pace” can get tricky when inflation is soaring in the city.
New York’s inflation rates squash those in other parts of the country. The Consumer Price Index shows that the price of medical care has surged in the New York and New Jersey area by 8% from Sept. 2021 to Sept. 2022. For all urban consumers in the country, meanwhile, the cost of medical care services has increased by 6.5% for the same period. The “modest” insurance cost increases from 2022 might not hold up in 2023 as inflation climbs higher, Kaiser’s report warns.
All of these factors are coming together at a time when employers are particularly concerned about staying competitive amid the great resignation–and as employees are asking for more from their benefits packages. Larger and smaller employers are handling that differently, whether it be by offering in-demand benefits such as fertility treatment coverage or by struggling to afford providing insurance at all.
A company’s size can also impact how it shares insurance costs with employees. According to Kaiser’s newest survey, in 2022 workers at small companies with less than 200 employees paid $7,556 on average for family coverage, while employees at large firms on average paid $5,580.
This trend “holds true” for many larger New York companies, said Candice Sherman, the chief executive of the Northeast Business Group on Health, a coalition of businesses and benefits providers in the region.
“Given their interest in retaining valued employees and attracting new ones, [larger] employers are reluctant to pass on any higher premium costs to employees right now,” she said.
In the aftermath of the pandemic, there is one area in which New York’s employers are sticking with national trends: mental health coverage. According to Kaiser, about 27% of employers surveyed nationally added mental health providers to their networks in 2022. Experts say that employees continue to rank mental health as one of the most important aspects of coverage, and New York employers are figuring out what to add to their packages. Many venture capital investment firms are beginning to invest in New York City startups tackling serious mental illness, as well. —Jacqueline Neber
The costs employers will incur providing health care to employees are expected to increase by 5.6% next year, according to early results from consulting firm Mercer’s latest survey of employers.
In the report, which was released June 22 and remains open, 864 employers across the nation responded by Aug. 4. The 5.6% cost increase for next year is significantly higher than the 4.4% increase that was predicted for this year, and 2023’s predictions still lag behind national inflation rates. Mercer predicted that employers have not fully felt the effects of inflation. The 5.6% prediction reflects changes employers would make to “hold down” costs.
“Because health plans typically have multiyear contracts with health care providers, we haven’t felt the full effect of price inflation in health plan cost increases yet. Rather it will be phased in over the next few years as contracts come up for renewal and providers negotiate higher reimbursement levels,” said Sunit Patel, the company’s chief actuary for health and benefits. “Employers have a small window to get out in front of sharper increases coming in 2024 from the cumulative effect of current inflationary pressures.”
Mercer does not have specific data on New York employers’ responses yet.
Eric Linzer, chief executive of the New York Health Plan Association, which works with 29 employers across the state that provide coverage for 8 million New Yorkers, said the rising costs of providing benefits are “inextricably tied” to the rising costs of health care—which won’t be going away anytime soon.
Linzer cited higher prices that doctors, hospitals and pharmaceutical companies are charging for care and drugs; ongoing costs for Covid-19 testing, treatments and vaccines; and legislative moves that drive up the cost of insurance, such as the $6.5 billion the state collects on health plan taxes annually.
Despite the rising costs, Linzer said, members of the association remain focused on providing quality care for their employees.
Survey results echo that. According to Mercer, employers are prioritizing increasing the benefits they provide next year while focusing on affordability for employees. Most employers reported they would not raise employees’ deductibles or copays. While 36% of employers said they would make cost-cutting decisions next year, that is down from 40% this year and 47% last year.
Mercer’s survey suggested that employers will not be increasing workers’ share of the cost of coverage next year. Large employers—companies with 500 or more workers—reported their employees would have to pick up 22% of health care premiums through paycheck deductions. That holds stable from this year and last year.
Candice Sherman, chief executive of the Northeast Business Group on Health, which is based in the Financial District, said the group’s members are focused on providing care that takes the impact of the last two years into account.
“Prioritizing benefits to retain and attract employees is definitely what we are hearing from our members,” Sherman said. “Employers are also keenly aware of the toll the pandemic and sociopolitical issues have had on overall employee health and well-being, including mental health, and want to ensure they are offering and communicating about a continuum of support, including a robust EAP and digital options.”
She added that making sure care is affordable for employees with lower incomes is a priority as well.
Linzer said the same for employers in his association, adding that many are trying to negotiate better reimbursement rates with doctors, hospitals and pharmacies.
Patel told Crain’s that health care costs are likely to soar next year, and Mercer expects employers will need to change the way their employees seek and get care.
“Strategies may include promoting the use of higher quality providers,” he said, “leveraging technology [such as] virtual health [and] remote monitoring and improved clinical management.”
Although Mercer said the Covid-19 pandemic’s impact on the price of care has been “fairly modest” thus far, that could change.
“We do expect that as provider contracts are renegotiated (which will be accompanied with larger increases than in the recent past), new, expensive gene and cellular therapies are introduced and staffing shortages ease, these will add to the growing cost pressures,” Patel said.
The predicted 5.6% jump in the cost of providing care next year would not be as significant as the increase in 2021, when employers’ costs rose by 6.3% to an average of more than $14,500 per employee. New York has the highest price of care per employee—more than $17,000 in 2021, Mercer reported.
Mercer, which is headquartered in Midtown, is a subsidiary of global firm Marsh McLennan. —Jacqueline Neber and Maya Kaufman
Racial disparities in healthcare have become point of focus for employers during the pandemic, not least because of COVID-19’s impacts. According to a February analysis by Kaiser Family Foundation, cumulative data showed that Hispanic individuals represented a larger share of COVID-19 cases relative to the total population, whereas Black individuals represented a slightly higher share of deaths compared to the total population.
Other diseases show similar disparate impacts. According to a March 2022 report published by the Northeast Business Group on Health, Black, Indigenous and people of color populations had disproportionate rates of obesity and diabetes. The report also found that inequities in care access were a major driver in health disparities.
What they're saying: "It's a serious issue for employers," said Candice Sherman, the CEO of the Northeast Business Group on Health. The group represents roughly 80 large companies such as American Express, Colgate, Moderna and Pfizer.
In a flipbook promoting health equity in employers’ diabetes and obesity intervention efforts, the Northeast Business Group on Health (NEBGH) recommended that employers take seven steps to ensure that their interventions are designed and implemented with health equity in mind.
These steps included incorporating the chronic disease interventions into overarching diversity, equity, and inclusion strategies, assessing programs for care gaps and inequities, reducing financial barriers to chronic disease prevention and management tools for minority populations, and adopting a value-based insurance design.
In April, the Northeast Business Group on Health, an employer-led coalition of business leaders and healthcare stakeholders, released “Obesity, Diabetes and Racial Health Equity: What Employers Can Do.” The guide is intended to help employers improve benefits-related outcomes for employees with obesity and diabetes, a commonly associated condition, with a special focus on employees of color.
“The science of obesity is unequivocal that obesity is a disease, not an individual’s fault or merely a product of lifestyle choices or environmental conditions,” the guide stated. “People with obesity are often viewed as lacking willpower or self-control and having psychological problems that limit their ability to restrict food intake.”
The weight stigma that arises from misunderstandings about the condition isn’t just a psychological tax on workers with obesity, the guide noted. It also results in underuse of healthcare benefits that can treat the condition and potentially improve their quality of life.