Employers have an extended listing of considerations relating to healthcare, and on the high of that listing is value, one professional stated.

“Employers are extraordinarily involved about value. They’re centered on most of their high value drivers,” stated Agnes Quiggle, principal well being transformation collaborative chief at Mercer, a consulting agency. Quiggle made these feedback Tuesday throughout an interview at HLTH 2023 in Las Vegas. 

The highest value driver for employers is most cancers, she famous. Most cancers overtook musculoskeletal situations on this class final yr, in keeping with Enterprise Group on Well being. Quiggle stated that most cancers diagnoses are “growing quickly” and individuals are residing longer with the illness.

Pharmacy spending can be a key driver of healthcare prices, Quiggle said.

“Our purchasers are very centered on, what does their formulary seem like? What are they approving? What are they not approving?” she stated.

A part of that concern over pharmacy spend is GLP-1s, which assist the remedy of kind 2 diabetes and weight problems, she added. The medicine are thought of a breakthrough for these situations however include a hefty price ticket.

“[The GLP-1 conversation] has simply exploded over the previous yr,” Quiggle stated. “The associated fee is so important that employers wish to guarantee that they’re doing the precise factor for the member and serving to them the place they’ll but additionally ensuring that it’s truly evidence-based and clinically applicable for these individuals to be on these medicines.”

What can employers do to handle prices? A technique Mercer is working with employers is by speaking to them about high-performance networks and ensuring that “high quality and value are balanced.”

“There are a ton of suppliers on the market who’ve actually poor high quality scores they usually value far more than the usual charge,” Quiggle stated. “So let’s a minimum of attempt to eradicate these suppliers. We don’t have to slim the community vastly, however let’s do a top quality assessment and exclude these individuals since you wish to pay a minimum of for common or higher high quality.”

In terms of most cancers prices, Mercer is encouraging employers to work with most cancers assist distributors, who may also help with most cancers screenings and supply help when sufferers obtain a prognosis. This might embrace referring sufferers to the precise suppliers and 24/7 chatting with coaches. Quiggle didn’t identify any of those distributors who present most cancers assist, however one instance is Thyme Care.

To handle prescription drug prices, Quiggle stated it begins with figuring out who the precise associate is.

“Is it somebody by a collective? Is it one of many large three PBMs? Or are you an employer that’s keen on going to a clear PBM, which there are lots of extra of?” she stated. “That is simply going to be your value of the drug plus a margin that could be very clear, and you realize what it’s going to be, type of just like the [Mark Cuban Cost Plus Drug Company] mannequin.” 

As well as, Quiggle additionally really helpful that employers take a look at the digital care supplied of their well being plans.

“To handle prices, you wish to guarantee that these digital care plans are usually not duplicating different visits since you don’t wish to double pay for a digital go to after which they should go in individual,” she stated.

Photograph: Ta Nu, Getty Pictures