If you’re an employer, we probably don’t need to tell you that today’s labor market is tight. U.S. unemployment is at a 17-year low, and labor shortages are expected to continue into the next decade. Jobs are growing faster than the labor pool can expand to fill them.
With gaps in the supply of skilled labor available, it’s a challenge to keep a full and healthy workforce. That’s the common theme of three trends we’re watching in 2018.
Our economy has been growing and producing jobs steadily since the end of the Great Recession in June 2009. Back then, there were 7 job seekers for every 1 job opening. Today, the ratio is almost 1 to 1. And there are additional factors squeezing the supply of U.S. workers. Birth rates are lower, and there is less migration into the U.S. People already in the U.S. are less willing to pick up and move for a better job. And there are significant gaps in the skills required to fill jobs in sectors that are growing.
The labor crunch means more competition to attract workers. It also means more investment in keeping employees productive and on the job. Which brings us to the underpinnings of our 2018 trends: workforce health and engagement.
Trend #1: Appealing to Multiple Generations in the Workplace
Health concerns look very different to a 24-year old than they do to a 54-year old. But in this labor market, employers will likely see growing numbers on both the lower and upper ends of the working age spectrum.
- Baby Boomers (1946-1964) – the youngest turn 54 this year. It’s a generation that’s retiring later and living longer.
- Generation X (1965-1981) – they’ll range from 37 to 53 in 2018.
- Millennials (1982-2004) – this year, the oldest Millennials turn 36. Millennials are now the largest generation in the U.S. labor force.
The American Institute for Preventive Medicine points to the need to understand differences in generational attitudes toward health improvement. We don’t assume a diabetic will benefit from an asthma program. In the same way, we shouldn’t assume that a single health promotion approach in the workplace will yield the same benefit for Millennials and Boomers. For younger workers in general, the need is to prevent low risk from becoming high risk. For older workers, the need is to help higher risk become lower risk.
Aon has found that older workers themselves focus on disease prevention and physical health, while younger workers are more likely to see social and emotional well-being as important. At any age, employees who say their workplace has a strong culture of health and good communication strategies are more likely to place importance on multiple domains of health, including physical, financial and social well-being.
What’s coming up in 2018?
In the months to come, we’ll share much more on generational preferences in accessing medical care and employee well-being engagement. What do people need help with? How can we reach them? What will move them to action? Each of these questions includes different answers for different generations. Building that culture of health that crosses generations will be a focus of 2018.
Trend #2: Savings from Utilization Slows, Pressure to Hold Down Prices Grows
For consumer-directed healthcare to successfully hold down costs, two things must happen at the same time. First, consumers need to believe they’ll be able to manage their own healthcare, and not give up. Second, they need access to useful resources that will help them manage their care wisely.
The hope is that when employees bear greater financial responsibility, they’ll drive down cost and excess utilization. The fear is that they will sacrifice necessary healthcare to avoid out-of-pocket costs.
When employees have a choice of plan types, they tend to select a PPO over an HDHP, according to Barbara Gniewek, PwC, Principal, Health and Welfare practice. “There’s been a lot of bad press on high deductible health plans – that they may be keeping people away from care that they need,” says Gniewek. But the plans have been popular with employers. Healthcare inflation in 2018 is expected to trend up 6.5%, a higher increase than in recent years. With that, many employers want to hold down their benefit cost by moving to greater employee contributions. HDHPs have fully replaced other plan types for 28% of employers.
But PwC says that the shift to offering exclusively high-deductible plans is not happening as quickly as once expected. The competitive labor market may again be the reason. Employers are looking to contain costs, but they’re trying to find strategies other than asking employees to pay a larger share. It’s getting more difficult to shift additional costs onto employees and stay competitive in the labor market. If cost-shifting was pushing down utilization, and that dynamic changes, rising prices will become a more obvious issue. Employers will look to supply-side strategies to hold down their overall cost. Networks will narrow. Navigation will increase in importance. And there will be more targeted emphasis on delivering value-based care – the right care to the right person at the right time in the right place.
What’s coming up in 2018?
In the coming year, we’ll look more at the increasing role onsite clinics play in this shifting scenario. We’ll explore how onsite clinics can fully support employees who have HDHPs. And we’ll see how onsite clinics are positioned to deliver on the promise of value-based care.
Trend #3: Recognizing Patients as Consumers and Customers
Back when dinosaurs roamed the earth, patients followed the doctor’s orders even as the doctor smoked. We’re all a lot wiser now, and there’s a growing understanding that when it comes to the quest for better health, patients and providers are in it together. It’s more than a philosophy of mutual respect. It’s also a very practical approach. “Finally,” says Dr. David Levine of Harvard Medical School, “clinicians are realizing that just because we say, ‘You should do that,’ a patient will not necessarily comply with our recommendation.” A shared decision between provider and patient is likely to improve adherence. It’s also important to know what barriers patients face in their everyday lives. A chronic condition especially will require adherence for the long term.
“It all begins with listening,” says Nancy Plemmons, FNP-C, Director of Clinical Development for Healthstat. “When you listen, you let people know that you care about them. That’s how you build trust into the patient relationship. It lets people open up to you.”
In fact, better communication has been shown to improve satisfaction on both sides of the stethoscope. And ultimately, this is associated with better clinical outcomes.
The challenge on the road ahead lies in overcoming what’s being called the dilemma of health inertia. On the one hand, we’ve done a good job raising awareness of things like healthy eating and the importance of exercise. Most Americans will now say that healthy eating and physical exercise are the key to a long and healthy life. On the other hand, people perceive that they’re eating healthier and exercising more than they really are.
What’s coming up in 2018?
We’re moving into a new era of designing programs around the people they serve. We’ll still be meeting people where they are, and inspiring them to move forward. But we’ll also be more focused than ever on knowing what drives people and how we can enable them to move toward their own definition of success. We can’t rely on moving people with information that’s strictly clinical or educational anymore. We need that personal appeal to consumer behavior and consumer emotions. We need to touch people home and heart.
There’s so much more to come from Healthstat in the year ahead. Each of these trends will be covered in greater depth. They’re on track to impact you and your employees, and we want to make the most of our opportunity to learn and grow together. We look forward to having you with us as we create new healthcare delivery landscapes and inspire healthy change!