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Midwest Business Group on Health Comment Letter to IRS on 'Cadillac Tax' (IRS Notice 2015-16) (PDF)

"The Cadillac tax is a unique revenue generating mechanism that presumably targets excessively generous employer-sponsored health insurance packages, thereby increasing incentives for the prudent and efficient use of care. The tax is not intended to work at cross purposes with the general concept of employer-sponsored insurance, undermine the overall movement toward consumer directed care or hinder an employer's ability to offer cost effective strategies for improving the health and wellbeing of their workforce. The regulatory implementation of Section 4980I must serve these narrowly tailored objectives."

41% of Employers Considering Private Health Insurance Exchange for Benefits Delivery by 2018, 6.4% Have Already Implemented (PDF)

"The Private Exchange Evaluation Collaborative (PEEC) is an initiative launched by four leading nonprofit business coalitions (Employers Health Coalition, Midwest Business Group on Health, Northeast Business Group on Health, and Pacific Business Group on Health) and PwC.... The survey is intended to help employers understand how their peers are thinking about private exchanges, their timelines for consideration and what features they view as critical, and to highlight what types of information about private exchanges are most important to employers."

Forum Panelists Say Health Care Benefit Changes Needed

Excerpt: Fundamental changes in health care and employee benefit programs are needed to solve the problems of soaring costs, low care quality and access to health care services, a panel of experts said Friday, July 24. Speaking at a Chicago forum on national health care reform and its effect on Illinois, the panelists outlined major problems in the health care system and suggested ways to address those issues. 'Employers' house of benefits needs an extreme makeover,' said Larry Boress, president and CEO of the Midwest Business Group on Health, a Chicago-based coalition that hosted the forum with the National Coalition on Health Care.

Employment-Based Health Care Coverage Still Working for Employers

"Plenty of pundits said the health care reform law -- with provisions that set up state health insurance exchanges and federal premium subsidies for the low-income uninsured -- would erode or kill employer-based plans. But [the Midwest Business Group on Health] survey shows no evidence of that."

Employers Acting as Early Adopters and Catalysts for Change as Health Care Purchasers

"Top employer health benefit priorities for 2024 are a focus on engagement in programs and use of benefits, chronic condition management, high-cost medical claims, and wellbeing/building a culture of health. Greatest threats to affordability of employer provided coverage are high-cost pharmacy claims, specialty drug costs, high-cost medical claims, and medical inflation.... Strategies for covering GLP-1 anti-obesity medications are covered with prior authorization (49% currently do so and 25% are considering), covering with risk stratification such as BMI and comorbidities, and not covering due to lack of evidence."

Employer Priorities for Health Benefits Include Employee Engagement, Communications and Managing Costs

"Top employer health benefit priorities for 2023 include a focus on engagement in programs and use of benefits (96%), health benefit communications (94%), financial wellbeing (93%), wellness and wellbeing (93%), chronic condition management (91%), preventive services (91%) and specialty drug management (91%)."

Employers Continue to Address Health Benefit Cost and Workplace Programs in Uncertain Times

"There's high priority by 73% of employers to increase engagement in their programs, 51% will offer telemedicine services, 55% of employers are committed to create more effective communications and a culture of health (47%), and 43% see managing specialty drugs as their highest priority. To reduce costs, employers are primarily focused on offering high deductible health plans (HDHP) (69%), targeting wellness programs (58%) and increasing employee cost share (49%)."

Onsite Clinics Are a Key Component to a Successful Health Benefits Strategy

"A majority of respondents of all sizes said the financial objectives for their onsite clinics are being met, with 64% seeing a reduction in medical care costs, almost 70% realizing reduced time lost by employees leaving work to see outside medical providers, and 63% had reduced use of the emergency room.... While most employers do not charge for clinic services, many are unaware of the need to charge employees with Health Savings Accounts a fee reflective of market prices. Over a third of employers with clinics do not consider their onsite clinics as part of their benefits plan, and there is uncertainty in how to value a clinic for purposes of the ACA's excise tax computations."

Growing Number of Employers Acting as Catalysts for Change to Shift Health Benefits Market and Drive Innovation

"Employer top health benefit priorities for 2021 include ensuring members are engaged in the programs offered and using benefits, along with COVID-19 related initiatives and chronic condition management. Top payment reform strategies being used now or planned in 2021 consist of specialty drug management (89%), centers of excellence/episodes of care (75%) and steerage within networks (69%). Top threats to the affordability of employer-sponsored health coverage consists of specialty drug costs (72%), high-cost claims (64%) and specific diseases and conditions (46%); about 15% of respondents don't see industry consolidation or intermediary conflicts of interest as a threat."

More People Have Health Insurance, But the Choices Are Narrowing

"Outside the exchanges, insurers are also promoting smaller networks for employers as a way to reduce overall health care costs, said Larry Boress, chief executive of the Midwest Business Group on Health.... Employers remain concerned about the quality of the networks, said Mr. Boress, and many are doing an analysis to see how disruptive changing the network would be for their workers. Nonetheless, the bottom line is that more employers are considering smaller networks."