Employers are always looking for ways to reduce one of their biggest expenditures–the cost of providing health insurance to employees. Many employers have explored solutions such as adding wellness plans, reducing usage, and providing different provider access mechanisms, all with modest success. Stemming the rising costs of health insurance requires management to understand and improve healthcare outcomes for their employee and dependent populations. Changing the future of employer health insurance will require a multi-faceted approach: Driving additional value by reducing utilization of healthcare services within these employer populations. Utilizing a wider lens through which to view performance of various providers, then making decisions based on those who are consistently providing low cost, high quality care. Employer will need to combine their data with other companies across a geographic region to get a better picture of the provider landscape than has ever been possible before.

1. The Future of Employer
Health Insurance

2. © 2019 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Employers in the United States are constantly
looking for ways to reduce what has historically
been their number two or three largest
expense item on their profit and loss
statements—healthcare costs.
Some surprising headlines have made waves
in the business world:
The Future of Employer Health Insurance
Starbucks spends more on
healthcare than coffee beans.
General Motors is a health and benefits
company with an auto company attached.

3. © 2019 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
While both statements are historically true, U.S.
employers–including both GM and Starbucks–
understand the challenge represented in keeping
their workforce and their loved ones healthy.
It’s both expensive and complex.
The Future of Employer Health Insurance

4. © 2019 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
In the same timeframe, the number of large
firms (defined as 1,000 employees or greater)
that moved from a fully-insured to a self-
funded plan grew from 62 to 90 percent.
The reason is simple: large companies (with a
greater sample size), utilize the greater
predictability of larger populations.
Because of this, insurance providers were
able to sell the financial benefits of self-
funding a covered lives population to
employers at a lower price point than
what was historically possible.
The Future of Employer Health Insurance

5. © 2019 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
This has largely been a function of improved
efficiency in the financial structure, allowing
providers to squeeze more and more value
out of the self-insured concept, enabling
lower pricing for large firms over time.
It’s becoming increasingly difficult to
squeeze incremental value out of simply
increasing the efficiency of these tried-and-
true financial instruments.
The Future of Employer Health Insurance

6. © 2019 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
What will this look like?
Employers are even now waking up to the
realization that they really don’t understand
the healthcare expense line item as well as
they do other major lines of expense that drive
their business.
The first step in this journey will be better
access and understanding of the healthcare
data that, to date, most employers have done
very little to understand.
Where Employer Health Insurance is Headed

7. © 2019 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Self-funded employer plans have every
incentive to understand this cost structure,
despite the complexity that exists, but to date
most do not have effective ways to measure,
predict, and manage this cost structure.
The future of employer health insurance will be
in driving additional value by reducing utilization
of healthcare services within these employer
populations while viewing provider
performance.
Then, decisions can be made based on
those providers consistently maintaining
low cost, high quality care.
Where Employer Health Insurance is Headed

8. © 2019 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Historically, the only source of data available
to an HR team was retrospective, months-old
claims file data that typically only tells a part
of the story.
Claims data is great to specifically detail
what procedures and treatments were
approved and paid for by insurers, the
company, and ultimately the employee.
This data is point-in-time, event-specific,
and usually driven by some incident or
ongoing problem.
Sources of Data

9. © 2019 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
It is only recently that more constant, wellness-
driven data, like heart rate, caloric and fluid
intake, daily exercise, and steps taken can be
combined in a solution to make a difference in
how individuals evaluate their personal health.
Trackers, such as Fitbits and the like, are
making significant inroads into this market.
In 2018 Fitbit announced a new initiative to
more tightly couple the data gleaned from their
devices into a program and help employers
better understand the wellness and financial
status of employee and dependent populations.
Sources of Data

10. © 2019 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
This is a trend that will continue to grow, as
technology further converges to bring devices
and infrastructure together, allowing for sharper
resolution into what drives health and wellness,
and what interventions most effectively improve
outcomes and lower cost.
Sources of Data

11. © 2019 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
In addition to improvements in how employers
track and collect health and wellness data from
individuals, strides forward have recently been
made in the ability for infrastructure to integrate
this data together in ways not possible in the
recent past.
These infrastructure improvements fall along
two pathways. The first is the ability to see a
more complete picture for an individual.
Placing exercise, calorie, fluid, biometric, and
sleep data in one place, and in context with
each other, allows individuals to make better
decisions.
Infrastructure

12. © 2019 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Correspondingly, taking that same data and
combining it with claims data and clinical data
across an entire employee population allows
management to make much better decisions
across the entire population around quality of
care and cost.
In the future, it will also be possible to combine
these employer data across geographies, thus
using larger sample sizes to drive quality and
cost recommendations with more precision.
Infrastructure

13. © 2019 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Finally, once employers have the data sources
and infrastructure, there is still a missing piece.
Who can best utilize this data on behalf of
employees?
One could argue that frontline healthcare
professionals, not the HR department, can best
make use of the data to inform best practices.
While true that the data is invaluable in the
hands of the Chief People Officer to create the
best benefits program for employees, the day-
to-day should be left to clinicians and primary
care providers by empowering them to drive
clinical effectiveness and reduce costs.
Bringing it All Together

14. © 2019 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
One example of this new paradigm can be
found in the increase over the last ten years in
primary care clinic providers aimed at the
employer health insurance space.
There are several examples in the market who
are doing well in this space: Crossover Health,
One Medical, and VillageMD are a few names
that come to mind in the United States.
Singapore-based Fullerton Health, with more
than 500 clinics across eight regions in
Southeast Asia is an international provider
also doing innovative things in this space.
Bringing it All Together

15. © 2019 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Each of these providers understand this
fundamental reality:
While employers–and, to a lesser extent,
employees–are the ultimate payers in most
healthcare systems, employees get a little
queasy when the boss knows too much about
their own personal health situation.
This is one downside of the data revolution
we are living in—so much data heightens
privacy issues, and calls into stark contrast
the fears that, through data, our own health
could be used against us.
Bringing it All Together

16. © 2019 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
While safeguards are in place, and this fear is
largely misplaced, the entire system works
much better when placed squarely in the
hands of the person and group who can use it
to greatest effect – primary care providers.
Bringing it All Together

17. © 2019 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Forward-thinking primary care providers under-
stand this shift and are working hard to incorporate
all sources of data into a provider model that
retains the best while minimizing the risks.
Allowing healthcare professionals to have this
data at their fingertips minimizes privacy risks
while allowing these professionals to prescribe
treatments and recommendations based
on the totality of data.
This hopefully prevents issues that would
have historically worsened, costing more
money and decreasing productivity.
Bringing it All Together

18. © 2019 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
For more information:
“This book is a fantastic piece of work”
– Robert Lindeman MD, FAAP, Chief Physician Quality Officer

19. © 2019 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
More about this topic
Link to original article for a more in-depth discussion.
The Future of Employer Health Insurance
The Missing Ingredient in Healthcare Analytics: The Executive Sponsor
Ryan Smith, SVP, Professional Services
Addressing Healthcare Waste Through Centralization
David Grauer, MBA, MHSA, Senior VP, Professional Services
A Framework for High-Reliability Organizations in Healthcare
Health Catalyst Editors
Employer Health Plans: Keys to Lowering Cost, Boosting Benefits
Jeff Selander, Senior VP, Emerging Markets
Transforming Healthcare Analytics: Five Critical Steps
Ann Tinker, MSN, RN, Senior VP, Professional Services; Dan Hopkins, Senior VP, Professional Services

20. © 2019 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Other Clinical Quality Improvement Resources
Click to read additional information at www.healthcatalyst.com
Currently serves as Senior Vice President, New Markets, with focus on the employer and
Asia Pacific markets Prior to this Jeff served as the Chief People Officer and Chief Financial
Officer for Health Catalyst. Prior to joining Health Catalyst, Mr. Selander was CFO at HB
Ventures, a private equity firm in Boise, Idaho. Health Catalyst was Jeff’s fifth start-up as a
venture finance professional, and his third as CFO.
During his career, Jeff has assisted CEO’s in raising over $250 million in debt and equity from
institutional investors. Before joining HB Ventures, Jeff was the CFO for Great Basin Scientific, a pre-
revenue life sciences start-up. Previous to Great Basin, Jeff played several senior finance roles for
iBAHN Corp., a venture-backed high-speed Internet provider to the hospitality industry. Mr. Selander
holds an MBA from the F.W. Olin Graduate School of Business at Babson College, Boston,
Massachusetts and a BA in international relations from BYU.
Jeff Selander

21. © 2019 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Other Clinical Quality Improvement Resources
Click to read additional information at www.healthcatalyst.com
Health Catalyst is a mission-driven data warehousing, analytics and outcomes-improvement company
that helps healthcare organizations of all sizes improve clinical, financial, and operational outcomes
needed to improve population health and accountable care. Our proven enterprise data warehouse
(EDW) and analytics platform helps improve quality, add efficiency and lower costs in support of more
than 65 million patients for organizations ranging from the largest US health system to forward-thinking
physician practices.
Health Catalyst was recently named as the leader in the enterprise healthcare BI market in
improvement by KLAS, and has received numerous best-place-to work awards including Modern
Healthcare in 2013, 2014, and 2015, as well as other recognitions such as “Best Place to work for
Millenials, and a “Best Perks for Women.”