There is a lot of uncertainty in the U.S. around healthcare, both for employees and employer-sponsored health plans that impact over half of the population. To deal with the growing bill of providing health benefits to their employees, many employers have responded with shifting the cost to employees. This trend is reflected in the rapid-growth of High-Deductible Health Plans (HDHP) in recent years. In fact, about 52 percent of employers offered a minimum of one high-deductible health insurance plan to employees in 2015. With the proposed repeal and replace plan for Obamacare, the trend of higher healthcare costs will likely accelerate.

While HDHP health plans are becoming more prevalent, they don’t necessarily address the core issue of reducing the unit cost and improving care outcomes and patient experience. According to a recent survey from Kaiser Family Foundation, out of every five insured patients, two admitted delaying or skipping physician-recommended tests or treatment because of high associated costs.

While employers continue to struggle to provide quality care to their employees and control costs, especially under this uncertain time, there are steps that employers can take to achieve their goal.

Utilizing the bundled payment concept, employers can contract directly with top-quality providers, bypassing the administrative layers between employers and providers with top-quality providers, called Centers of Excellence (COE). As background, a bundled payment is defined as a single comprehensive payment made to healthcare providers—hospitals and physicians—for a group of related services, based on the expected costs for a clinically defined episode of care. CMS announced its Bundled Payment for Care Improvement (BPCI) Initiative in 2011, and around the same time, some of the largest employers in the country, such as Walmart, Boeing and Lowes, decided to use the bundled payment program. These programs were successful in generating significant cost savings for employers while dramatically improving the quality of care and experience for employees.

Setting-up a bundled payment program is not limited to Fortune 100 companies like Walmart or Lowes, however. There are many ways that mid-size and small employers can engage in bundled payments to ensure that the program works with all population needs. Here are three steps to make the concept work for any size company:

Step 1: Determine your patient population needs. For example, a public-sector client, who had around 6,000 eligible members, realized that 40 percent of their overall healthcare spend came from 8 percent of their members. Some of the top healthcare expense categories for employers are musculoskeletal and cardiac procedures. These typically are high-volume and high-cost surgeries –making them for great bundled payment targets because they present an opportunity to improve results through standardized care.
 
Step 2: Set up your COE program. Initially, employers’ set-up such program themselves by contracting directly with top-quality providers. This can be a very expensive undertaking for the clear majority of employers. Even for the large employers, these programs can become challenging to scale. To address this issue, some breakthrough solutions are emerging in the market that make such programs accessible to employers of all sizes.

Step 3: Actively engage the population. There are many ways to do this from the traditional benefits communication to the more turnkey approach of building it into benefit plan designs. Employers that have seen the most traction are proactively driving member communication using traditional as well as big-data analytics approaches and making changes in the benefit designs to incentivize adoption.
 
Despite all the changes in healthcare, there are things that employers can do to take cost out of the system versus sharing it with employees, all while providing high-quality care to patient employees and ultimately improving the bottom line. Bundled payments present a clear opportunity for employers to not only improve healthcare outcomes and experience for their employees, but also do ‘savings sharing’ instead of ‘cost-shifting’ to employees.