Top 3 Pharmacy Benefit Design Strategies for 2020

Top 3 Things You’ll Learn

  1. Projected health care costs per employee in 2020
  2. How to protect your plan against unnecessary spending
  3. Why your employees are demanding an evolved service model

The total cost of employer health benefits is expected to rise 5% this year with cost management initiatives taken into account, according to the National Business Group on Health’s (NBGH) 2020 Large Employers’ Health Care Strategy and Plan Design Survey. The survey also revealed that the total cost of health care is estimated to be $15,375 per employee, including premiums and out-of-pocket costs for employees and dependents.

Total cost of health benefits could rise 5% this year. Top management strategies inc. greater oversight of high-cost Rx. #drugcosts

Discover how you can curb your health care costs in 2020 with this list of the top strategies that surveyed employers plan to implement or continue this year:

  • Focusing on prescription drug benefits – Prescription drugs have gradually been taking over as the most expensive part of employee health care benefits. To effectively manage the specific cost drivers impacting your bottom line, you need to zero in on the pharmacy benefit. The most effective way to do that is to carve-out the pharmacy benefit from the medical carrier and work directly with a pharmacy benefit manager who exclusively focuses on managing prescription drugs. Choosing to stay carved-in will pose a greater challenge in effectively identifying and addressing the pharmacy-related factors driving your health care costs.
  • Zeroing in on high-cost claims – This strategy made the list in 2019, but it’s no surprise that managing high-cost drugs remains a major priority for employers. Brand-name and specialty medications still account for almost 50% of drug spend while accounting for less than 2% of claims. Through your pharmacy benefit provider, you can access valuable programs and tools that provide plan protection against unnecessary spending on high-cost drugs.
  • More virtual care solutions –As the use of technology expands, consumers are demanding more immediate service to address their health care needs. They want greater access to their providers and immediate answers to their concerns, and they want it available at their fingertips. This trend is influencing employee service models and points to the need for new, virtual care solutions. You will need to meet this demand by showing your employee members that service – in both an in-person and on-demand format – is a top priority.

See how this compares to the previous survey that revealed the top benefit design strategies employers planned to use in 2019.


Business Group on Health

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