Revisiting employee benefits managers

Area of Science:

• Health Services Research
• Healthcare Management
• Employee Benefits

Background:

• Employers' health benefit strategies evolved significantly between 1991 and 1998.
• A shift from traditional indemnity plans to managed care was observed.

Purpose of the Study:

• To examine changes in health purchasing practices by Employee Benefits Managers (EBMs).
• To understand the influence of EBMs on health plan design and employee decision-making.

Main Methods:

• A longitudinal case study approach was employed.
• Interviews were conducted with EBMs in a medium-size metropolitan area in 1991 and 1998.

Main Results:

• Employers reduced paternalism in health benefits.
• A notable shift occurred from indemnity coverage to managed care options.
• Employee cost-sharing increased, with greater decision-making authority transferred to employees.
• EBMs actively influenced provider networks and performance requirements, but quality information utilization remained minimal.

Conclusions:

• Employer health benefit strategies became less paternalistic and more employee-centric.
• Managed care adoption and increased employee cost-sharing characterized benefit trends.
• EBMs played a key role in shaping health plans, yet a gap exists in leveraging quality data for decision-making.