Medcom Blog


Increasing Concerns with High Deductible Health Plans

Just as with groceries, gas, and everything else, healthcare has not evaded the effects of inflation. It’s a tricky balance as employers try to retain and hire employees through attractive benefit programs. To combat high costs, more employers have started to offer high deductible health plans (HDHPs) because premiums for these plans are lower and they come paired with a Health Savings Account (HSA) to help pay for qualifying out-of-pocket medical expenses. Even with those incentives, HDHPs may not be helping as much as they thought, according to the Trends in Drug Benefit Design Report recently published by Pharmaceutical Strategies Group (PSG).

The research in this report centered on perceptions and challenges around HDHPs, the role of member experience, formulary strategy, and how the Great Resignation and pandemic have shifted plan design priorities.

“Plan sponsors must constantly review trends and adjust plan design and programs to meet current needs and marketplace conditions. This research puts a microscope on benefit design, offering insight into how to be proactive and innovative to create affordable and accessible pharmacy benefits,” stated Michael Lonergan, RPh, President of PSG.

Here are some key takeaways from the report:

  • Only 35% of respondents agree that HDHPs manage overall drug trend (down 6% since 2018)
  • 51% agree that HDHPs help members
  • 57% of respondents mention member acceptance as a barrier to trend and UM programs; 33% say reducing inappropriate utilization is their top goal outside of managing trend
  • Out of the 81% that use formulary exclusions, 69% of respondents say member dissatisfaction is a top challenge with formulary exclusions
  • 41% of respondents say the importance of member experience has increased somewhat or greatly since the start of the pandemic; 27% report the Great Resignation has impacted their benefit strategy

The respondents from this survey included individuals representing employers, unions/Taft-Hartley plans, and health plans who reported being responsible for managing their organization’s pharmacy benefit. Covered members for these respondents included active and retired employees and their dependents.

Times are changing, and employee benefit plans need to keep up. Earlier this year, on our blog, we discussed the future of employee benefits. Read our blog titled “Next Generation Benefits” to ensure your clients are keeping up with the trends and attracting and retaining the best talent.

Don’t forget that earlier this year, the IRS released the limit for HDHP out-of-pocket expenses and the minimum deductible.

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