2019 Annual Report
The need for employers to work collaboratively to combat rising health care costs and industry consolidation grew throughout 2019 and Employers Health was again there to answer that need! The accelerating growth in our collective purchasing solutions, particularly those for pharmacy benefit management (PBM) services, is a direct result of the value our clients realize on an ongoing basis and independently validated by their consultants. To that end, we added 29 new purchasing clients representing more than $200 million in annual pharmacy spend.
82% of respondents in our client satisfaction survey said lowering total prescription drug costs was an extremely important part of their 2019 benefits strategy. Drug pricing has received attention on both the national and state levels and we’re sure to hear additional proposals during this election season. For our part, Employers Health clients benefited from pricing improvements tied to our annual market evaluation and contract negotiation with both CVS and OptumRx. Additionally, we added a third PBM to our portfolio of solutions – EnvisionRx.
Our team at Employers Health also continues to grow. We added five full-time professionals in the areas of account management, analytics and clinical pharmacy to ensure we continue to deliver on our promises to clients. We’re proud of the accomplishments of so many on our team, including completing graduate degrees, earning the Certified Employee Benefit Specialist (CEBS) designation and the many hours of volunteerism to our neighbors and local communities. As our team grows, we are focused on creating the right culture and are pleased to be recognized again as a Great Place to Work.
For certain, 2020 will present additional challenges and opportunities for our clients and teams and our work in 2019 positions us well to navigate these changes. We are appreciative of the time, effort and energy that so many have contributed in 2019 and look forward to even more collective
success in 2020.
Best Regards,
Greg & Chris
Gregory T. Troy
CHAIRMAN OF THE BOARD
Christopher V. Goff, Esq.
CEO & GENERAL COUNSEL
Mission
Employers Health is committed to providing resources, tools and expertise to help plan sponsors deliver high-quality health care benefits at a sustainable cost.
How we accomplish our mission:
- Managing group purchasing strategies.
- Benchmarking and data interpretation.
- Building physically and mentally healthy workforces.
- Sharing ideas and best practices.
- Collecting and analyzing market intelligence.
- Supporting population health improvements.
- Creating an environment where all team members bring their best selves.
Vision
Employers Health will be a premier, nationally recognized employer-led organization with a focus of:
- Earning the trust of our clients and their consultants as a reliable and consistent resource for unbiased, objective resources and expertise.
- Managing a variety of growing and market-leading collective purchasing solutions including pharmacy, medical and ancillary benefits.
- Achieving consistently-high levels of client and participant satisfaction and loyalty by delivering on our promises and helping employers achieve their desired results.
Value
Employers Health brings value through a host of solutions that help our members achieve:
- Affordable, high-quality health care benefits.
- Healthier employees who are more productive in their individual jobs, thereby creating better organizational performance.
- An informed workforce that interacts with the health care delivery system more effectively, leading to better health outcomes and lower costs.
- Fully engaged, resilient employees who can more effectively meet the challenges of today’s work and family environments.
- Work cultures with aligned incentives that produce employee loyalty and create “great places to work.”
Breakdown of Group-size
OF EMPLOYERS HEALTH AND CVS CLIENTS:
OF EMPLOYERS HEALTH AND OPTUM CLIENTS:
Annual Market Check & Pricing Evaluation
Within a constantly changing and consolidating industry, employers are challenged to ensure their contracts remain competitive. Employers Health ensures groups that participate in one of its PBM programs receive the most aggressive pricing and contractual terms available in the market through the market check process it undertakes with each of its PBM suppliers.
With over 100 evaluations annually, the Employers Health pharmacy benefit management contracts are among the most scrutinized in the industry. In addition, each year Employers Health engages at least one national pharmacy practice to benchmark its pricing against pricing generally available in the market. With these data and the collective size of the Employers Health book of business, the Employers Health in-house legal team annually negotiates with each of its PBM suppliers to ensure that every group participating in an Employers Health PBM program achieves aggressive pricing and contemporary contract terms.
The market check process that Employers Health undertakes on behalf of its participating groups has led to an overall negative trend and helped Employers Health participating groups offset the costs associated with changing drug mix and price inflation on brand drugs – specifically, treatments for diabetes, rheumatoid arthritis and chronic preventative medications. Moreover, an independent third party audits the performance of each of its PBM suppliers relative to each Employers Health participating group to ensure contractual compliance. While findings through the audit process are rare, Employers Health participating groups receive 100% of any audit recoveries.
The market check and independent third-party audit are critical differentiators enjoyed by all Employers Health participating groups. They ensure that each participating group continuously experiences market-competitive pricing and contractual terms. These facets of Employers Health PBM programs when combined with the unparalleled clinical and client solutions support create a PBM program experience that is second to none.
We value relationships. We make your objectives ours and build trust through collaboration. We believe in integrity, which means you can be confident that we will honor our commitments. We care about innovation and will continuously encourage and invest in new ideas. We are accountable. We take our responsibilities seriously and strive to deliver results for your business. And we are relentlessly focused on quality, for all our stakeholders, as a business imperative.
EyeMed Vision Care knows that your eyes – and the eyes of your employees – are amazing. They see everything, everywhere and everyone. That’s why EyeMed offers Employers Health members the network employees want with vision benefits that redefine expectations, all while making the experience easy for both you and your employees.
ComPsych Corporation is the world’s largest provider of employee assistance programs and is the pioneer and worldwide leader of fully integrated EAP, employee wellness and work-life services under its GuidanceResources® brand. By creating “Build-to-Suit” programs, ComPsych helps employers attract and retain employees, increase employee productivity and improve overall health and well-being.
Smiles are important, and since dentists can detect more than 120 symptoms of non-dental diseases, it’s essential to follow good oral health habits for better overall health. Delta Dental is the largest and most experienced dental benefits carrier in the U.S. and is committed to oral and overall health.
Employers Health Solutions (EHS) provides niche consulting and project management services for employers where gaps in the market or conflicts with existing consultants occur. In these instances, EHS provides a straight-forward, unbiased service for a flat fee. Examples of services provided include, but are not limited to:
Benefits Administration Services Evaluation
Many employers find that the consultants they rely on to evaluate solutions for Benefits Administration also have their own in-house solutions they wish to be considered. Because of these conflicts of interest, organizations turn to Employers Health Solutions for help. In the past year, our team has worked with clients, including a large institution with more than 10,000 employees, to conduct a formal RFP for these services. Clients appreciate the process and expertise that EHS has developed in this area.
Consultant Selection
Employers select their consultant partners in a variety of ways. For those wishing to conduct a more formal and structured evaluation, few third-party organizations have the knowledge to provide valuable assistance with the process. EHS has created a robust yet efficient process that helps employers analyze the capabilities of various consultants and evaluate their fee structures. Both clients and consulting firms praise EHS for its approach and prudent process.
Right Direction is an effort from the Center for Workplace Mental Health, a program of the American Psychiatric Association Foundation and Employers Health Coalition, Inc. and is supported by Takeda Pharmaceuticals, U.S.A., Inc. (TPUSA) and Lundbeck U.S.
Clinical Support
As employers struggle to deal with a growing pharmacy spend, strategies to manage these rising costs are increasingly important. The Employers Health clinical team continuously monitors our book of business, often recommending and implementing custom clinical solutions to ensure appropriate use and exclusion of high-price, low-value drugs.
Our clinical team proactively identifies opportunities to more tightly manage the formulary and develops custom clinical strategies that clients can implement, resulting in sustained or improved clinical outcomes at a lower cost. Actively managing utilization, coupled with our focused management of the contract, consistently drives a flat trend across all of our clients.
Over the past four years, Employers Health clients have benefited from these custom and exclusive options, saving groups in total around 2-4% of total spend annually. Many of these strategies are adopted by the PBM through formulary changes, but often years after Employers Health clients benefited from their implementation. In 2020, three new strategies will be introduced for probiotics, dry eye and expensive dosage forms.
Client Support
We’ve built a dedicated team to help you enhance results and achieve your goals all while improving the participant experience. Each Employers Health client is assigned a dedicated account manager who provides strategic oversight, customized support and ongoing vendor management. We are committed to providing you with an exceptional experience each and every time.
Our client solutions team works with you to navigate a complex system, proactively monitoring trend and implementing custom solutions to benefit your plan and its participants. The team coordinates implementations, monitors spend and trend and delivers innovative solutions for your unique needs. As an extension of your benefits team, we work hand-in-hand to serve as your advocate.
Our clinical and client solutions teams, together with a team of pharmacy benefit professionals, strive to support our goal of helping member organizations achieve better outcomes and better experiences at a better cost.
An employer-led group purchasing coalition, our interests are aligned with those of employers. Employers Health is governed by a board of directors comprised of employers like you.
Standing (left to right): Garrett Brown, Assistant General Counsel, Steven Burger, Chief Financial Officer, Christopher Goff, Chief Executive Officer and General Counsel
Sitting (left to right): David Uldricks, Vice President, PBM Contracting and Strategy, Mike Stull, Chief Strategy Officer, Zach Hostetler, Vice President, Account Management
- “Employers Health provides great value to our benefits team through collaboration on the CVS PBM contract.”
- “A real partner in cost savings for our pharmacy spend. We also enjoy the annual meetings they put on to help keep us up-to-date on trends in the market.”
- “The CVS program offered through EH is of great value because it provides Rx cost management strategies, negotiates pricing and rebates and stays ahead of Rx trends.”
- “The yearly market check provides knowledge that is beyond the resources we have available. The meetings and newsletters provided throughout the year are extremely helpful in remaining current in the PBM arena. The in-person meetings are also extremely beneficial in terms of networking with peers.”
- “Employers Health provides a ‘second set of eyes’ to ensure accountability from the PBM. It helps coordinate ongoing open communication with the PBM and keeps track of important issues.”
