What AHA’s Affordability Recommendations Mean for Employers

In our previous blog, we examined what the AHA’s affordability recommendations could mean for patients. Now we turn to another critical stakeholder group: employers.

For employers, healthcare affordability is often measured in rising premiums and benefit costs. As healthcare spending has increased over time, employers have faced difficult choices about compensation, hiring, investment and benefit design. Healthcare costs affect businesses of all sizes, from large national employers to small businesses struggling to provide comprehensive coverage for their workers. And even policymakers must grapple with this from the perspective of employers, given the large local, state and federal workforce.

One of employers’ primary tools to manage costs over the past decade has been to simply shift more of those costs onto employees by increasing premiums, copayments and deductibles or by cutting back on benefits. This may have helped contain employer cost growth, but it has also created financial and administrative barriers to care for employees and their families. And some of those cost savings may have been short-term, if important primary and preventive care services became less accessible and resulted in the need for more complex care later.

There is no single solution that will instantly lower healthcare costs for employers without significant tradeoffs. However, the AHA’s report, Making Health Care More Affordable: A Blueprint to Lower Costs, Improve Access and Enhance Quality, outlines several practical steps that can help address the underlying drivers of health spending rather than continuing to simply shift costs.

Helping Employees Stay Healthier

One of the most effective ways to improve affordability is to reduce the need for costly care in the first place.

Many of the highest healthcare costs are associated with chronic conditions that can be better managed, or even prevented, through stronger primary care and earlier intervention. Expanding access to preventive services, ensuring consistent and affordable access to important maintenance drugs, and strengthening patient relationships with primary care providers can improve health outcomes while reducing the need for more expensive care later. Employers benefit when workers stay healthy, manage chronic conditions effectively and avoid preventable complications.

Supporting Better Care Coordination

The AHA blueprint also supports continued expansion of coordinated and value-based care models, including accountable care organizations. These models support providers in working together to improve outcomes, reduce duplication and better align incentives across the healthcare system.

For employers, better coordination can mean fewer unnecessary services, improved quality and more efficient use of healthcare resources. In some markets, employers may even have opportunities to contract directly with coordinated provider organizations that can deliver high-quality care while helping manage costs.

Reducing Administrative Waste

One of the clearest opportunities to improve affordability is reducing administrative complexity.

Today's healthcare system relies on countless transactions among providers, insurers, employers and third-party administrators. Many of these processes involve significant paperwork, repetitive documentation requirements and inefficient workflows that add cost without improving patient care. Greater standardization and simplification can reduce administrative burden across the system and lower costs for employers and employees alike.

Administrative simplification is not just a provider issue. Employers ultimately bear many of these costs through higher premiums and benefit expenses. Eliminating unnecessary administrative requirements can help create a more efficient healthcare system for everyone involved.

Giving Employers Better Information

Employers also need better information to function as effective purchasers of healthcare.

The AHA's recommendations support stronger transparency tools that help employers understand what is actually being spent on care, evaluate network performance and make more informed decisions about benefit design. In particular, we support expanding the capacity of all-payer claims databases that reflect the actual amounts paid for healthcare services. These tools can provide employers with more reliable information about healthcare spending and value.

Better Value for Employers and Healthier Workforces

Employers need affordability solutions that do more than shift costs from one part of the system to another. They need solutions that improve workforce health, reduce unnecessary spending and deliver better value over time. By focusing on prevention, better care coordination, administrative simplification and greater transparency, the AHA's recommendations offer a practical path toward a healthcare system that works better for employers, employees and the communities they serve.