For most of my 25 years in the benefits industry, the pace of change has been more evolutionary than revolutionary. However, the past few years have seen a noticeable expansion of innovation and services offered through benefits plan providers.
Here are my top five picks for benefits trends and issues to watch in 2019:
1. Virtual health care
As our mobile phones morph into extensions of our appendages, we are becoming remarkably comfortable integrating technology into just about every aspect of our lives — and health care is no exception. A little over a year ago, telemedicine, or virtual health care, burst onto the Canadian scene, offering just what we needed to help alleviate issues related to under-serviced rural and remote communities, as well as wait times in clogged emergency rooms and clinics.
While only six per cent of Canadian employers currently offer this service to their employees, according to Morneau Shepell Ltd.’s 2019 HR trends survey, if statistics from our southern neighbours are any indication, this benefit is poised for growth in Canada. The number of Americans using virtual health care doubled in just one year, with 75 per cent of large U.S. companies currently offering the service to employees, according to research by Dialogue.
Technology-based health solutions are also helping Canadians deal with issues like mental health and chronic pain. Internet or digitally based cognitive behavioural therapy focuses on the development of personal coping strategies and skills that target solving current mental-health problems by changing unhelpful patterns of thought, beliefs, attitudes and behaviours. Apps such as Manage My Pain and Curable are also helping those with chronic pain to form new neural pathways in the brain, reducing pain symptoms and reliance on prescription drugs.
2. National pharmacare
Canada is the only country in the world with a universal health-care system that doesn’t include universal drug coverage. The idea of a national pharmacare program has resurfaced many times over the years, but this time it seems possible. All political parties appear to have at least some support for the concept, but they’re still debating what shape it will take.
My hope is that any national pharmacare plan complements, without completely replacing, the existing framework of private and public plans, which is working reasonably well. With any luck, it will address the segment of the population with no coverage, the growing burden of specialty and high-cost drugs on employers and the relative price that Canadians pay for prescription drugs compared to other countries.
3. Predictive analytics
Employers used to rely heavily on experience, advice and their gut instinct when making decisions related to their benefits programs. These days, employers and their benefits providers are sitting on mountains of data, and technology is increasingly helping to consolidate different sources of data and run analytics, which can uncover hidden current and future risks in their employee population. For example, combing absence data with an understanding of the factors typically present in employees before the onset of a disability claim can help employers provide support to those high-risk individuals before they result in a longer-term claim.
4. Pharmacist-led deprescribing using therapeutic nutrition intervention
Some recent clinical trials have shown very positive results in reducing or eliminating prescription drugs, including insulin in some type 2 diabetic patients, through pharmacist-led therapeutic nutritional intervention. In the study, patients adhered to a low-carbohydrate diet (i.e., ketogenic diet). And then, through close, consistent monitoring by their pharmacists and physicians, they were able to reduce or eliminate medication in a safe and effective manner.
The financial impact for employers with patients on this program can be significant. In one case, presented at Benefits Canada‘s 2018 Calgary Drug Trends Summit in October, a 59-year-old overweight diabetic male who was taking 10 medications at a cost of nearly $8,000 annually was able to lose 45 pounds and discontinue all medications in a period of just five months. This focus on holistically helping the person versus treating a symptom with medication can save organizations money in the long run.
In 2018, we saw continued consolidation among benefits consulting and advisory firms with large global players like Hub International, Arthur J. Gallagher & Co. and People Corp. leading the charge. It’s becoming increasingly challenging for smaller brokers to keep up with the rate of change, so this trend is likely to continue for the foreseeable future.
We are also seeing consolidation in the form of providers offering one-stop shopping for all employers’ human resources and benefits needs. A prime example is Sun Life’s recent partnership with Rise People to offer HR, time tracking, payroll and benefits administration, all brought together in a single system and helping to streamline these processes for small- and medium-sized employers.
These are exciting times in the benefits world. While employers face many challenges, including rising costs and meeting the needs of a diverse workforce, benefits providers continue to respond to these needs by offering new solutions for managing costs, increasing efficiencies and improving the overall employee experience.