Employers' anticipated healthcare prices, which mirror the anticipated annual proportion improve in affected person therapy prices, rose from 6% in 2022 to almost 8% in 2025, in keeping with a brand new examine from the Enterprise Group on Well being.

“That’s the best projection we’ve seen on this examine in over 15 years,” Ellen Kelsay, president and CEO of Enterprise Group on Well being, mentioned at a press convention. “And at that fee of improve, if compounded, well being care prices shall be over 50% of 2017 ranges by 2025. What’s worse, this well being care inflation is predicted to proceed.”

The Enterprise Group on Well being’s 2025 Employer Well being Care Technique Survey, launched Tuesday, acquired responses from 125 massive employers overlaying greater than 17.1 million lives. Extra findings embrace:

1. Pharmacy prices are a serious driver of value will increase. In 2023, the median proportion of healthcare {dollars} spent on pharmacy prices was 27%, in comparison with 24% in 2022 and 21% in 2021. Roughly 76% of respondents mentioned they had been “very involved” about pharmacy prices. To handle pharmacy prices, employers’ prime methods in 2024 embrace maximizing “producer copay program advantages” and implementing “new packages/options supplied by my current PBM associate.” Nevertheless, 40% are contemplating implementing PBM transparency by 2026 and 2027.

2. GLP-1s shall be a serious driver of well being care prices in 2024. About 56% of respondents mentioned GLP-1s will drive well being care prices “very a lot” or “enormously.” Moreover, 70% mentioned they’re “very involved” in regards to the applicable use and long-term value implications of GLP-1s and different weight administration medicines. About 96% of employers cowl GLP-1s for diabetes, and 67% cowl them for weight problems. To handle GLP-1 use, the most typical tactic employers use is prior authorization.

3. When requested about circumstances that can drive up well being care prices in 2024, 80% of employers cited most cancers, 74% cited musculoskeletal circumstances, and 40% cited cardiovascular circumstances. About 87% of employers mentioned they may have not less than one most cancers screening methodology in place by 2025.

4. The estimated complete value of care per worker in 2024 is $18,639, up from $1,438 in 2023. Nevertheless, employers don’t plan to move this value improve on to workers. The estimated out-of-pocket value for workers in 2024 is $1,825, up from $1,831 in 2023.

“The vast majority of that improve is being absorbed by employers by way of plan premiums and contributions to worker well being accounts,” Kelsay mentioned. “That is the third yr in a row that almost all employers have chosen to soak up these elevated well being care prices in an effort to maximise affordability for workers and their dependents.”

5. To handle prices, employers will reevaluate their provider partnerships. Many plan to make use of the Request for Proposal (RFP) course of to barter higher costs and finish relationships with underperforming suppliers. By 2025, one-third of employers mentioned they may consider or use the RFP course of for his or her PBM. When evaluating well being plan and PBM partnerships, employers mentioned claims/utilization knowledge, knowledge measurement, and transparency are vital.

“These findings actually mirror employers’ considerations in regards to the high quality of knowledge they obtain from suppliers and the significance of correct knowledge to base choices on,” Kelsay mentioned. “Companions which might be in the end in a position to ship high-quality, clear companies and supply extra strong reporting and credible measurement shall be considered extra favorably as employers conduct these evaluations.”

Picture: Ta Nu, Getty Photos