3 cost-management strategies for employee health care coverage

Health care spending in the U.S. is expected to top $6 trillion by 2028. Perhaps even more noteworthy: 25% of that spending could be due to overtreatment, low-value care, fraud and other factors.1

Within that percentage lies a cost-management opportunity.

For an employer, it can be work that ensures they’re offering a high-value health care program that’s cost-effective — not only for the organization but also for its employees and their families.

Here are three examples of strategies that have been shown to be effective in dealing with certain health care costs:

1. Clinical and care management

A study found that 38% of consumers made health choices that were less than optimal for their health situation.2 A clinical and care management strategy that uses advanced analytics to identify employees with chronic and high-cost conditions may create opportunities for better health care choices and overall cost savings — by helping them understand what services are available.

For instance, in some UnitedHealthcare plans, clinical data can be used to help identify employees at risk for chronic, high-cost conditions, allowing nurse advocates to reach out and gauge interest in proactive support and to alert employees about clinical programs available through their coverage.

2. Network and product design

Research has shown that access to primary care is associated with positive health outcomes and that primary care providers (PCPs) can influence $0.59 of every health care dollar.3 A network and product design strategy centered around high-performing PCPs — and systems that deliver quality and efficiency — may make it easier to direct care appropriately, so members receive the right care at the right time.

For example, Point of Care Assist® can integrate an employee’s UnitedHealthcare health information into a provider’s electronic medical record. This merge of data gives the doctor real-time insights on care opportunities and a look at an employee’s specific benefits, including prescription coverage and costs, which may help identify lower-cost options.

3. Employee engagement initiatives

Giving employees tools and resources to help them maintain or make steps toward a healthier lifestyle may be another powerful approach. 

An employee engagement strategy that includes wellness and weight-loss programs tied to rewards for healthier choices may help prevent or manage chronic conditions — which may ultimately promote better health, improved productivity and lower overall costs.

For example, UnitedHealthcare Motion® promotes physical activity using a digital tracker and provides financial incentives for meeting certain daily fitness goals. Additionally, a program called Real Appeal® supports weight loss by building healthy habits across key areas, such as nutrition, fitness, sleep and stress. It is available at no additional cost to eligible UnitedHealthcare members and dependents as part of their health plan benefits.

For a deeper dive into these cost strategies, watch the video below to hear regional UnitedHealthcare leaders explain how they help organizations manage the total cost of care. Or read a white paper on this topic.

1 Shrank WH, et al. Waste in the U.S. Health Care System: Estimated Costs and Potential Savings. JAMA. 2019.

2 UnitedHealthcare National Accounts Book of Business, 2019.

3 National Health Expenditures, 2020 Highlights. Centers for Medicare & Medicaid Services.