Julie Mueller, President & CEO,  Custom Design BenefitsJulie Mueller, President & CEO, Custom Design Benefits
One thing is constant in health benefits: employers continue to grapple with their quest to attract and retain good employees by offering the best and most relevant benefits, balanced against the rising cost and constraints of these benefits. As we look at 2021, we see some trends emerging from this core need for benefit cost control and flexibility, while others are emerging or rapidly expanding at least in part due to Covid-19.

• Telehealth Services: We’ll see continued rapid growth in the adoption of Telehealth services. A 2020 McKinsey Covid-19 Consumer Survey showed that consumer utilization of Telehealth services increased from 11% in 2019 to 45% in early 2020. That utilization rate will continue to increase as providers seek to treat a higher volume of patients, and consumers get more comfortable with virtual office visits. There has been a significant increase in mental/behavioral health issues in 2020, a trend which will still play out in 2021. The rising demand for quick access to behavioral health services will further amplify the adoption of Telehealth services.

• Elective Surgeries: Consumers will continue to postpone elective surgeries until a Covid-19 vaccine is widely available to, and used by, the general public or the perception of risk has decreased.

• FMLA: The Family and Medical Leave Act nuances always present challenges for employers to understand and navigate, but the extension of employer subsidies and the shifting political and regulatory environment will add additional complexity in 2021. Originally set to expire at the end of 2020, the ever-changing Families First Coronavirus Response Act has also been extended through March 21, 2021. Looking at our data, to date in 2020 there has been a nearly 75% increase in leaves managed over prior year, with 34% of those attributable to Covid-19.
We expect that to continue in 2021 as schools, employers and employees adjust schedules and adapt to changing situations, recommendations and regulations. Once Covid-19 has passed, we’ll continue to work through many of the state-level FMLA changes that were once planned for 2020 but were postponed during the pandemic.

• Specialty Drugs: Soaring prescription drug costs and the need for transparency to control those costs are becoming a primary concern for employers. Specialty Drugs, which are often submitted as a medical claim to avoid pharmacy benefit scrutiny, play a considerable role in this cost escalation and as a result deserve specialized attention. In 2021 we’ll see the evolution of enhanced referenced-based pricing programs that use price and evidence-based dosing data to put parameters in place to contain costs. Additionally, we’re working to establish relationships that will remove the cost for these Specialty Drugs from an employer’s benefit plan by seeking alternative funding for the employee, often in the form of a grant from the drug manufacturer. It’s a win for employers because costs are contained, and a win for employee members because they still get access to the Specialty Drugs they need.

• Direct Primary Care: Direct Primary Care has been popular in rural areas on a smaller scale for quite some time, but this patient/doctor “fixed price” relationship model is gaining traction for good reason. In establishing direct contracts with healthcare providers, employees and employers benefit from reduced costs for services because the insurance “middleman” has been eliminated. We expect this model will gain significant traction in 2021 because it offers both a personalized healthcare plan and experience and price transparency.