Survey shows that employers focus mostly on finances when evaluating health plans

February 11, 2025

Information Tracked by Companies or Their Health Benefits Administrators

Source: Pfeffer, J JAMA Health Forum January 31, 2025

Research just published in JAMA Health Forumshows that employers primarily focus on finances when choosing a medical carrier. This is no surprise, given that employers are now facing the highest premium increases in the last two decades.

Over 80% of employer respondents reported that their health plans provided information on spending, while about a quarter reported on the number of prior authorizations denied (26%) and number of grievances or appeals (23%). Only one in six plans reported on member satisfaction (17%), and only 6% of employers reported that plans reported on employees delaying or forgoing care due to the plan’s actions such as denials. The researchers found that employers regularly asked their consultants for information on cost projections, benchmarks and plan design, and were much less likely to request that their consultants provide information on quality and monitoring of employee health.

Implications for employers:

• Employers can improve the quality of their health plans by focusing on a balanced set of metrics that include both financial and non-financial items in both procurement and ongoing plan oversight. These metrics could include quality, utilization, and denial and appeals measures.

• Employers can gain valuable information if they press their medical carriers to report on quality, utilization review, and member experience.

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