Public Resources

The National Alliance of Healthcare Purchaser Coalitions (National Alliance) conducted a survey of employers and other private purchaser of healthcare with its members to gain insights on benefit strategies and reform.

The online survey was conducted in August and September 2020 and reflects the responses of 165 employers from across the country.

The recording and the survey are below. 

Key findings:

• Faced with record disruption in healthcare services and the economic downturn, employers are staying the course or accelerating (71% for 2021 and 63% for 2022) their health benefit strategies.
• Employers are open to a myriad of potential reforms with the majority indicating drug price regulation (94%), hospital price transparency (90%), surprise billing regulation (81%) and hospital rate regulation (79%) to be very or somewhat helpful.
• Employers indicated a Medicare public option (50%) could be very or somewhat helpful, while 21% felt it could be very or somewhat harmful. When asked about Medicare for All, 46% of employers indicated that would be very or somewhat harmful.
• Caregiving benefits such as leave (30%) and protected time to support employee caregiving needs (28%) have tripled since the start of the COVID-19 pandemic.
• Drug prices (90%), lack of transparency (73%), hospital prices (71%), surprise medical bills (58%), and overuse of low-value services/waste (53%) are greatest threats to affordability of employer-provided health coverage for employees and their families.
• Reducing waste and inappropriate care (61%) and steerage within networks (47%) are top delivery and payment reform strategies. Strategies being considered over next two years: hospital quality transparency (44%), hospital pricing transparency (43%), regional centers of excellence (39%), and advanced primary care (36%).
• Most prevalent medical and pharmacy drug strategy employers are currently doing: medication therapy management (49%).
• Top health and wellbeing strategies currently being implemented: flexible work week (65%), total person health and wellbeing (63%), navigation and advocacy services (55%), and enhanced mental health support (49%).
• Related to race, health and equity, a majority of employers indicated current efforts to encourage community volunteerism (71%) and engagement in community improvement (70%), and 58% said they are currently doing anti-racism education and cultural competency training (52%).