Offerings of HSA-eligible high-deductible health plans have more than doubled in the past five years. Our 2016 National Survey of Employer-Sponsored Health Plans found that more than half of large employers (53%) now provide this type of plan to their employees, and nearly a quarter of employees (24%) are enrolled. At the same time, there has also been steady growth in offerings of onsite and near-site medical clinics, especially among the largest employers: About a third of employers with 5,000 or more employees provide a clinic for primary care services. An onsite clinic offers the maximum opportunity for control over quality, and more than half of the clinic sponsors in another Mercer survey said that their clinic is integrated with their population health efforts.
Employers that offer HSA-eligible plans and provide onsite care face unique challenges. Under rules for HSA-eligible plans, only preventive services can be provided at no cost; employees need to pay the full cost of a non-preventive visit before they satisfy the plan deductible. Some employers with onsite clinics may be unknowingly disqualifying employees, understating their own tax liability, and incorrectly filing employment tax forms.
It remains to be seen if lawmakers will loosen regulations to make coordinating clinics and HSA-eligible plans easier. In the meantime, we surveyed 84 organizations that have onsite clinics and asked how employees are charged for clinic services. Of those respondents that offer both an HSA-eligible and non-HSA eligible plans, nearly two-thirds say that members are charged the same amount for clinic services, regardless of plan selection, though a third responded that members in the HSA-eligible plan are generally charged more. More than half of these employers that offer HSA plans charge a single, flat fee per visit for all services, 29% have a full fee schedule, and the remaining 17% have a tiered fee structure. Nearly a quarter of respondents use third-party services for billing, and just over half require full payment for clinic services at the point of sale.
Employers with onsite clinics that are considering adding an HSA-eligible plan will need to revisit their clinic fee structure and billing practices to ensure clinic use is compliant with plan eligibility -- at least until these regulations are updated… fingers crossed!
We were saddened today to hear about the loss of Carrie Fisher, best known for her role as Princess Leia in the Star Wars film franchise. As a tribute to the joy she brought us over the years, we’ve prepared a Star Wars themed challenge for our readers. Try to find all 17 Star Wars references below -- ask a fan if you need help! Then be sure to check back later this week -- the answers will be posted on Friday.
As the winter weather is finally upon us (can someone say brrr!) cold and flu season also strikes back this time of year, causing many employees to take time off to seek care. Some employees may want to rush to their nearest doctor to make sure they’ve gotten their flu shot, while others may try to be a trooper and just hope to avoid any illness this season. Holiday travel in crowded airports increases your odds of getting sick, especially if you make your return on the redeye and don’t get enough rest to boot! Getting an end of year appointment can be a menace, but employees have a new hope with retail health clinics. A long time ago, these may have been met with luke-warm reception, but now the retail health market is stronger than you could possibly imagine; many CVS and Walgreens stores operate these clinics, so they’re probably not far, far away from your home or office. Most clinics have a computer kiosk where you can enter your insurance information upfront and get an appointment time; some locations will even send you a text letting you know you’re next patient - advances in e-health sure has made access to care seem like an e-walk in the park! However, if your retail health clinic can’t provide the services you were looking for, don’t feel you have to go it solo in finding appropriate care. Employees don’t need to go rogue to find the right doctor; they can utilize health advocacy services, to laser in on specific providers to get the specific care they need. Employers – be sure to communicate these options to employees, so they can maintain their health and productivity during this season and you can ensure your workforce is with you.