Innovations in Employment-Based Health Benefits

In recent years, there have been many employer-driven “innovations” in health benefit design, such as health reimbursement arrangements, value-based benefit design, medical homes, wellness programs, and others. All of these innovations have a common goal: to better manage spending on health care through consumer engagement tools or the use of incentives that change individual behavior. What do we know about the effectiveness of these innovations? In large part, very little independent research exists on their impact. Premiums by plan type can be compared, and the use of preventive services can be tracked; but reliable, unbiased information regarding the true impact of these programs is scarce. Nearly a hundred health policy experts, senior private-sector HR representatives, and insurance and health officials examined some innovative employer-driven programs during a daylong policy forum held by the nonpartisan Employee Benefit Research Institute (EBRI) in Washington, DC, on Dec. 9, 2010. The discussion also considered the future of employment-based health programs in the wake of the November election results and enactment of the Patient Protection and Affordable Care Act (PPACA). This paper summarizes the presentations and debate during that forum. The PDF for the above title, published in the April 2011 issue of EBRI Notes, also contains the full text of another April 2011 EBRI Notes article abstracted on SSRN: “Retirement Income Adequacy: Alternative Thresholds and the Importance of Future Eligibility in Defined Contribution Retirement Plans.”