A survey of 560 employers with over 50 employees has been released by Deloitte. (Deloitte Survey) The survey questions focused on perceptions of the US health care system. About 95% of these employers currently offer health care coverage. About 65% of the respondents would give the system a C grade or lower and benefits management executives give it even worst scores. The aspects ranked most favorably are clinical and, as would be expected, the worst scoring attributes relate to cost and efficiency. Most employers seem to understand the aspects of the reform law that affect them directly fairly well, but do not understand delivery system changes as well. Most say they are not well-prepared for the 2014 changes stemming from the law. Sixty percent think the reform law is a bad piece of legislation. Employers continue to view health benefits as important in attracting employees and creating job satisfaction. About 10% of companies indicated they will drop coverage in the next few years, but they represent only 3% of the workforce, but another 10% say they might drop it.
Employers view exchanges as a method for changing how they deal with health care coverage costs, and the presence of exchanges may encourage some employers to shift to a defined contribution strategy and stop dealing with health plans directly. While some employers see direct contracting with provider networks as a possible cost containment strategy, most continue to rely on shifting cost to employees. Hospital costs, inefficiency and unhealthy behaviors are tagged as the contributors to excess cost growth, but employers have few clear strategies for dealing with the provider aspects of the problem. Greater use of wellness programs, primary care and preventive measures are all emphasized for helping individuals change to healthier behaviors. In general, employers are very concerned about federal deficit spending and health care’s role in that, and therefore favor drastic changes to those federal programs.