High-deductible plans haven’t encouraged employees to shop more effectively for health care because they haven’t been given the tools they need in order to do so.
With PBMs and high prescription drug prices back in the news, it’s worth asking once again: “Why did we design a health plan that has the ability to deliver a $1,000 surprise to employees?” It’s a good question. In a 2018 article that remains pertinent today, Bloomberg offers a portrait of an American healthcare system in collapse:
“39% of large employers offer only high-deductible plans, up from 7% in 2009, according to a survey by the National Business Group on Health. Half of all workers now have health insurance with a deductible of at least $1,000 for an individual, up from 22% in 2009, according to data from the Kaiser Family Foundation.” This despite the fact that, according to the Federal Reserve, a large and growing number of American families cannot afford a $400 emergency expense without borrowing or selling something.
Interestingly, these high-deductible plans were designed to encourage patients to make value-based decisions – to make us better shoppers so that we save money (for both the patient and the payer). Instead, many Americans arrive at the pharmacy counter to find that they simply can’t afford their medications.
Scripta has years of experience driving savings for self-funded companies and their employees. We contend that high-deductible plans haven’t encouraged employees to shop more effectively for health care because they haven’t been given the tools they need in order to do so.
The most startling thing about the Bloomberg article? Even companies like pharmacy Giant CVS are taking notice. (We would argue that they are nevertheless part of the problem, but we digress…) CVS noticed that as they pushed more costs onto employees, some stopped taking their medications. As a result, the company has recently announced plans to cover more care before workers are exposed to the cost.
CVS isn’t alone in questioning a system they say costs patients too much. JPMorgan’s CEO Jamie Dimon told Bloomberg, “We all thought high deductibles are going to drive people to get involved—skin in the game,” but instead, “they didn’t get the surgery they needed, when they needed it, because they can’t afford the high deductible in one shot.”
JPMorgan has since effectively eliminated deductibles for workers making less than $60,000 a year. Most self-funded companies don’t have that luxury, and that’s where Scripta can help.
Scripta works with self-funded employers and their trusted benefits advisers to eliminate surprises at the pharmacy counter. We arm employees with reports that help them understand ALL of their therapeutic options, and these same reports help guide discussions with caregivers, so that together patients and their doctors can take advantage of savings opportunities – saving money without sacrificing quality of care.
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