3 new and innovative ideas for healthcare cost containment

With employer health insurance costs expected to increase 6.4% in 2024, it isn’t surprising that 57% of employers are asking brokers for new and innovative ideas for healthcare cost containment, according to the 2024 Broker Survey by Optavise. Meanwhile, 42% of brokers cite rising healthcare costs as a market force leading their firms to add new services and products.

So how can brokers help their employer clients manage rising healthcare costs? Let’s explore three solutions.

1. Benefits Advocacy

With healthcare utilization and cost of care being two major factors driving employer healthcare costs, brokers and employers realize that employees have a large role to play in healthcare cost management. This is leading many brokers to offer benefits advocacy services to clients.

With a benefits advocacy service, employees have year-round access to benefits advocates whom employees can call on for assistance with their benefits and healthcare. Advocates can help employees with many things, such as:

• Assisting with any benefits or healthcare topic, including tracking down answers to questions, finding in-network doctors and more
• Finding ways to help employees save money by comparing costs for tests and procedures and looking for other savings opportunities
• Reviewing bills for errors
• Appealing denied claims
• Coordinating care and providing education for complex or chronic cases

When a benefits advocate helps an employee understand costs and comparison shop for care, the employee can find the best value for their money. For example, an MRI ranges in cost from $324 to $7,300 in the United States, according to Optavise national research. With help from a benefits advocate, an employee can be empowered to choose from a $2,500 MRI at the hospital—or a $550 MRI at the clinic across the street.

2. Prescription Drug Management Programs

Prescription drug costs climbed 8.4% per employee in 2023, and as a result, brokers report that employer clients are particularly interested in prescription drug management programs.

For example, 77% of brokers report that employers are interested in the GoodRx program, which gathers prices, coupons and savings tips to help manage high drug prices. Meanwhile, 68% of brokers say employers are interested in shifting to (or from) self-insured coverage. Additional drug management programs include:

• Mandatory generic drug substitution programs that will only cover the cost of generic medication whenever available
• Mandatory mail order programs with lower costs than local drugstores
• Step programs that require patients to try a lower cost prescription drug before “stepping up” to a similar-acting but more expensive drug

3. Point Solutions

Another strategy for helping employers manage healthcare costs is point solutions.

Point solutions are usually focused on improving specific areas of care, ranging from primary care and mental health to specific high-cost claims, such as diabetes, high blood pressure, cancer or weight management. Point solutions often utilize quality, cost-effective digital-first care vendors that help contain costs.

Our report found that 60% of brokers say that employers are interested in implementing point solutions.

Want more broker insight? Download our 2024 Benefits Broker Report.

Optavise is Your Benefits Partner

Optavise is a trusted partner, guiding employers and their employees through healthcare choices including voluntary benefits, benefits administration, and year-round advocacy services that reduce costs and increase benefits engagement.