Employer-Led Strategies to Improve the Value of Health Spending: A Systematic Review

Objective:To systematically review studies that evaluated the impact of employer-led efforts in the United States to improve the value of health spending, where employers have implemented changes to their health benefits to reduce costs while improving or maintaining quality.Methods:We included all studies of employer-led health benefit strategies that reported outcomes for both employer health spending and employee health outcomes.Results:Our search returned 44 studies of employer health benefit changes that included measures of both health spending and quality. The most promising efforts were those that lowered or eliminated cost sharing for primary care or medications for chronic illnesses. High deductible health plans with a savings option appeared less promising.Conclusions:More research is needed on the characteristics and contexts in which these benefit changes were implemented, and on actions that address employers' current concerns.