Large U.S. employers have become less satisfied with their health insurers, a study released by PricewaterhouseCoopers’ Health Research Institute shows.

Hit hard by the recession, employers of all sizes are taking a critical look at their health-benefits structure and the value they derive from it. They are looking to their health-plan providers for information, technology and strategies to help reduce waste in healthcare spending and better engage employees in managing their health.

In its report, "What Employers Want From Health Insurers in 2010: Better Information, More Value," PricewaterhouseCoopers LLP analyzes its study of nearly 250 employers, ranging from large U.S.-based multinationals to privately held small companies. The analysis looked at how employers viewed health plans in 2009 in 12 key service areas across four main categories: financial, customer service and claims administration, use of technology and population health management. The report builds on research started by PricewaterhouseCoopers in 2008.

Major findings of PricewaterhouseCoopers’ research include these:   

• Overall satisfaction of health insurers by large employers has decreased to 59% from 64% in 2008.
• Small employers continue to be less satisfied with health insurers than large employers, with overall satisfaction remaining steady at 52%, but the gap between large and small employers is narrowing as large employer satisfaction erodes.
• Employee cost-sharing continues to be the most prevalent strategy for employers. Sixty percent of employers surveyed said they would further increase cost-sharing for healthcare with their employees in the year ahead.
• Claims processing, administrative fees and provider discounts remain among the most important basic service offerings for large and small employers, though among large employers, wellness programs surpassed provider discounts as the more important offering.
• While wellness and disease-management programs are popular among employers, companies that offer them are frustrated with the low level of employee participation. Seventy-one percent of companies surveyed now offer wellness programs and 67% offer disease-management programs.
  Employee participation in wellness programs continues to hover at around 50%. Many employers are finding that simple financial incentives such as cash, gift cards and annual-premium savings are no longer working as a way to engage employees.
• Interest in personal-technology tools such as personal-health records and online comparison tools is surging. Nearly half of all employers say it is important for insurers to offer these tools, but less than half are satisfied with what they are getting.

“Employers recognize that it’s better to manage the health of their workforce than to manage the cost of illness, and they want their health plan to help manage the entire health continuum,” said Paul Veronneau, principal and U.S. healthcare payer leader, PricewaterhouseCoopers. “There is only so much insurers can do to manage health and cost through provider discounts or on the back end of a claim. This is an opportunity for health insurers to look beyond traditional strategies and get more aggressive about healthcare quality and value.”

What Employers Want from Health Insurers

The following are key recommendations for insurers based on PricewaterhouseCoopers’ analysis:

• Be a consultative partner with employers to help improve workers’ health and advocate for employer health strategies.
• Take a more active role in waste reduction.
• Offer better strategies for engaging employees in wellness and disease-management programs.
• Provide more meaningful, actionable and higher-quality data to build work-force profiles that will help employers better understand the health of their work force, find intervention points for better outcomes and create targeted outreach and engagement campaigns.
• Deliver consistent and transparent health-benefit-plan reporting.
• Provide personal technology tools for employees.
• Assist in the continuity and coordination of care among patients and physicians.
• Provide education that will simplify health plans and benefits, engage workers in real behavior change and translate benefit information into actions that promote wellness.

Large and Small Employers Align in What They Want

PricewaterhouseCoopers found that small and large employers are now more closely aligned in what they want from insurers than in 2008, when there were distinct differences between what each group considered most important.

The importance of wellness programs continues to be the area with the greatest gap between large and small employers. Nearly 80% of large employers indicate that wellness programs are important to them, compared with 57% of small employers. However, small employers are catching up in seeing the value of these programs. Wellness programs and personal-health records are the two service areas that experienced the largest increase in importance among small employers since the 2008 report.

Performance guarantees continue to be rated the least-important financial-service offering among large employers, dropping almost 20 percentage points in importance and satisfaction since 2008. This could indicate that employers aren't getting clear value from existing performance guarantees. According to PricewaterhouseCoopers, employers need better information on their employee population to determine how to structure performance guarantees to meet their expectations for health and financial outcomes.

A full copy of PricewaterhouseCoopers’ Health Research Institute’s "What Employers Want From Health Plans" is available online at www.pwc.com/us/whatemployerswant.

Methodology
PricewaterhouseCoopers’ Health Research Institute provided research-based insight by evaluating the results of two surveys: Executives at 100 large U.S.-based multinational companies (Management Barometer survey) and 130 privately held small companies (Trendsetter survey). Large companies had an average of 11,000 employees and revenues of $4 billion. Small employers had a work force of less than 200 employees and average revenues of $24.3 million. Data were collected in the second quarter of 2009 via a telephone survey conducted by the independent research firm BSI Global Research Inc. In addition, PwC HRI gained insight from a PwC survey of more than 650 human-resources executives (Health and Well-Being Touchstone Survey), which provided detailed benefits information and future healthcare strategies from U.S. companies in 30 industries.