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Willis Towers Watson recently conducted their 2020 Health Care Delivery Survey, in an effort to illuminate the strategies employers are using in their health care benefits and programs. Conducted in August and September of this year, the survey included responses from 397 organizations in the US, representing 7.1 million employees. Their research revealed that 73% of employers plan to adopt or expand new types of healthcare delivery models over the next three years, such as high-performance narrow networks and centers of excellence. This percentage is up from 53% that implemented these models in the previous three years.

In a statement from Julie Stone, Managing Director of Health and Benefits at Willis Towers Watson, she explained, “The cracks in our health care system are much more visible than they were just a few years ago… No longer satisfied with traditional strategies, an increasing number of employers are searching for ways to better manage quality of health care with emerging and more cost-effective delivery options.”

Employers’ chief concerns are with affordability and accessibility, especially as they pertain to mental health resources, as well as increasing the overall quality of care for their workers. Of those surveyed, there was overwhelming interest when it comes to expanding access to high-quality mental health services (84%) and substance abuse treatment (77%), as well as improving the affordability of specialty drugs (85%), mental health services (78%), and specialty care medical services (77%). There is also some concern over how to expand access to quality care for employees based in rural areas, where there are naturally less providers and options when it comes to healthcare services. 

In order to reach these goals, employers are turning to the following solutions:

  • Centers for Excellence (COEs)

Over half of employers surveyed offer a group health plan that includes access to COEs. As places that employ a high concentration of experts in a particular area of medicine, COEs can offer a high quality of care. For 21% of these plans, the use of COEs is mandatory. The vast majority of employers (92%) believe this is a way for their employees to receive a higher quality of care, and nearly just as many (82%) think that COEs can reduce overall annual health care costs. 

  • High-Performance Networks (HPNs)

Seventy-four percent of employers view HPNs as an effective way to improve quality of care. HPNs provide access to a narrower network of providers selected for their higher quality of care and/or lower cost. Of those planning to use an HPN, most (70%) plan to do so with a regional or local plan, instead of nation-wide one. Over a third (38%) of employers have adopted or are planning to adopt an HPN with 25% to 49% of providers in the market included; that number is slightly less (33%) for HPNs with 75% of more providers included. However, in order to offer a more restrictive network of providers (less than 25% in the market), respondents must expect there to be greater savings and improvement in the quality of care.

  • Telemedicine And Virtual Services

Only 3% of those surveyed did not offer some kind of access to telehealth or virtual care services, with 84% directly offering these services through their health insurance carrier. The majority of employers (77%) believe that virtual health visits can reduce costs, and 90% expanded access to telemedicine during the COVID-19 pandemic. Even after the pandemic, over half of respondents believe that these services will continue to be important in improving quality and access to healthcare. In the next three years, 17% plan to give employees access to health care “chatbots” powered by artificial intelligence. Employers also used these virtual solutions to expand mental health resources. Two-thirds of respondents specifically cover tele-behavioral health services through their insurance carrier, and another 24% offer these services through either a third-party telemedicine vendor or third-party behavioral health vendor.

  • Third-Party Intervention

Employers also used third-party digital, virtual, or coaching solutions to reduce costs and improve quality of care for mental/behavioral health (51%), metabolic syndrome/diabetes (37%), maternity care (29%), musculoskeletal conditions (19%), and cardiovascular conditions (19%).


Additionally, about a quarter of employees are making use of data on providers to steer their employees to the best value for care, with the help of either their health insurance carrier or a third-party vendor. Navigation services, where a third party performs customer service functions for employees, are being used by 17% of employers, with another 26% planning to do so in the future.


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