- Some 48% of healthcare consumers surveyed said improved insight into how much care would cost was the No. 1 item they were excited about when it came to innovation in healthcare.
- Employers can expect an increase of more than 20,000% in adolescent mental health telehealth costs, according to a study showing telehealth appointments cost an average $407 per member over the last year, up from just $2 in 2019.
- Half of large firms offering retiree health benefits did so through a Medicare Advantage plan in 2022, according to an analysis of survey data.
Over the past few weeks, I have found these industry news stories that should be of interest to healthcare finance professionals.
1. Knowing the cost of care ahead of time is the No. 1 innovation in healthcare that consumers are ‘excited about’
Some 48% of healthcare consumers said “improved insight into how much care will cost ahead of time” was the No. 1 item they were “excited about” with respect to innovation in healthcare, according to a survey conducted on behalf of Ribbon Healthcare.
“OnePoll surveyed 1,000 consumers across the United States on their experience receiving health care, which factors are most important to them when looking for and selecting care, and which factors they consider vital to a more personalized and inclusive care experience,” according to an Advisory Board Daily Briefing published Dec. 23.
Other innovations consumers applauded in the survey were:
- More accessible mental health services (39%)
- Telehealth options (37%)
- Artificial intelligence that will improve processes so doctors can spend more time with patients (20%)
“New technology is redefining how consumers experience healthcare, and there are a few key innovations that people are excited about,” wrote the report authors.
“Health plans should prioritize increased member insight into cost of care and highlight providers with telehealth services and behavioral health expertise,” they added.
How health plans can be more consumer-centric
“Although consumers view their insurance plan as the #1 factor for whether they have a positive healthcare experience, only 38% trust their health plan to find a provider,” wrote the authors.
Insurers could become more consumer-centric by providing the things that a plurality of survey respondents (37% for each item) said they want to see on their health plan’s website when searching for a doctor:
- More locally available network options
- Indications of which doctors are available to new patients
- At-a-glance appointment availability
For more insight, HFMA members can access HFMA’s Healthcare Dollars & Sense initiative, which provides industry-consensus recommendations and best practices for meeting consumers’ rising expectations, helping consumers make better healthcare decisions and improving the patient financial experience.
2. Pediatric mental health costs are expected to increase significantly in 2023
Employers experienced an increase of 20,250% in adolescent mental health telehealth costs in recent years, according to a study by Nomi Health. The study shows telehealth appointments cost “an average $407 per member per year (PMPY) in the last year, up from just $2 in 2019,” states a Dec. 8 news release.
“Data from the study also indicates the youth suicide attempt rate soared 55% from 2019 to 2021, and significantly more children and teens are receiving depression, anxiety and post-traumatic stress disorder diagnoses compared to pre-pandemic levels — up 12% between 2020 and 2021,” according to the release.
“This care crisis is also a cost crisis,” the report states, and that trend will continue this year. A Nomi Health claims analysis projects “a 186% increase in employer cost for 2023, at up to $4,000 per affected employee dependent, compared to approximately $1,400 in 2019.”
Other key findings
Additional findings from the study include:
- Inpatient care costs jump significantly once a youth hits their teens. In 2022, PMPY inpatient costs were $48 for elementary-age children, $502 for ages 13-15 and $624 for ages 16-19.
- The cost of youth mental health claims to employers was 27% higher for girls than boys in 2021-22 — up from a 20% gap in 2019. And the mental health diagnosis rate was 44% higher for girls than boys in the last year, compared to 26% higher in 2019.
The study “analyzed the mental health insurance claims of more than 156,000 patients ages 6-17 to reveal changes in employer spend, which is indicative of need and demand for care,” according to the release.
3. Medicare Advantage plans grow in popularity among large firms offering retiree health benefits
Analysis of data from the 2022 KFF Employer Health Benefits Survey shows that 50%of large firms offering retiree health benefits did so through a Medicare Advantage plan in 2022, which is up from 26% in 2017, according to a Kaiser Family Foundation (KFF) press release. Large firms are defined as those with 200 or more workers.
Authors of an article posted Dec. 1 on the KFF website noted this move away from retiree health coverage that was “typically designed to coordinate or wrap around traditional Medicare … could have implications for retirees’ core Medicare benefits.” This would be particularly true “if the only option for retirees is a Medicare Advantage plan, which may impose restrictions, such as more limited provider networks and prior authorization requirements,” added the authors.
Other survey results show:
- 13% of large employers offered health benefits to Medicare-age retirees in 2022.
- About 44% of large employers that offer Medicare Advantage coverage to their retirees do not give retirees a choice of coverage options, while 56% do offer a choice.
- Among employers with 1,000 or more workers that offer retiree health benefits through a Medicare Advantage plan, lower cost was the most commonly cited reason.
HFMA bonus content
Read the article “For the No Surprises Act arbitration process, 2023 brings a steep fee hike and continuing litigation,” by Nick Hut, HFMA senior editor.
Listen to the Voices in Healthcare Finance podcast episode featuring HFMA Director of Perspectives & Analysis Shawn Stack and Senior Editor Nick Hut sharing insight on No Surprises, disruptors and everything else that made healthcare industry headlines in 2022.