As US employers face a projected 11 percent increase in healthcare costs next year, the employee wellbeing industry is under mounting pressure to prove its value in hard dollars - not just engagement metrics.
Ed Liebowitz, President and General Manager of the Wellbeing Business at Personify Health, says the industry must earn its place in employer cost strategy, and he has a clear message for benefits brokers: start demanding better.
The market has shifted sharply. According to the Business Group on Health's (BGH) latest employer survey, 95 percent of employers say they would completely disrupt their benefit strategy to contain healthcare costs. That is a stark contrast to 2022, when 86 percent of employers in the same BGH survey ranked wellbeing platforms primarily as a tool for talent attraction and retention.
"I think wellbeing really needs to earn a place in an employer's healthcare cost strategy," Liebowitz said. "The industry needs to catch up to that value proposition and really figure out how to support employers in their new journey, which is exploding healthcare costs."
For Liebowitz, the opportunity lies in earlier intervention - engaging employees before they reach a high-cost clinical decision point. "The question is, how do you leverage data about that individual to help them avoid cost?" he said. "It's like saying I'm going to wait to fix my car until the oil light goes on. The earlier you do it, the cheaper it's going to be long-term."
Premium wellbeing platforms, he said, should not be evaluated on steps-challenge participation. The right metric is reduction in healthcare trend for engaged versus non-engaged populations and whether a platform can reach 100 percent of employees with actions that are meaningful to their individual health.
No topic is generating more broker and employer anxiety right now than glucagon-like peptide-1 (GLP-1) drugs.
Liebowitz compared the current GLP-1 wave to Sovaldi for hepatitis C but with a critical difference: GLP-1s were amplified by celebrity endorsements, direct-to-consumer pharmacies, and compounding pharmacies, putting access in the hands of consumers in ways that were never anticipated.
"It went from a $4 or $10 million a year healthcare cost to $30, $50, $60, $100 million a year," Liebowitz said. "And now employers are like, what do we do?"
For employers who want to fully fund GLP-1 therapy, Liebowitz recommends routing patients through certified obesity medicine clinics where trained physicians guide treatment. For employers that want to enable access while managing cost, he pointed to health reimbursement arrangements (HRAs) or lifestyle spending accounts (LSAs) tied to preventative care actions. "It really becomes healthcare funding and how to optimize that investment strategy versus do we offer this or not offer it to our population," he said.
Liebowitz pointed to what he sees as the biggest structural flaw in how the US group benefits industry procures and evaluates wellbeing vendors.
"We assume that people are a condition and that a single point-in-time solution will solve the challenges and the cost related to that condition," he said, drawing on his own experience as a person with type 1 diabetes and a concussion that required specialist neurology care. "If we can support that person, understand their needs, and not just navigate them to the highest quality physician, but navigate them to the system of care that is most meaningful to them, then that starts to solve the ecosystem problem."
On vendor ROI claims, Liebowitz urged brokers to be skeptical of white-paper benchmarks. "A lot of the ROI studies that have been presented by digital health are a bit cherry-picked and for early adopters," he said. "Early adopters are always going to allow you to do better. The question to me is really, what's the ROI that you deliver at scale across a diverse customer base?"
His recommendation for benefits advisors is to identify whether a client has a specific condition burden - diabetes, MSK, cancer - and ask vendors to demonstrate how they have supported comparable clients at scale, not just cite aggregate ROI figures.
He also emphasized the importance of actuarial integrity, noting that ROI models should normalize for unpreventable events while remaining realistic about sample sizes. "If your N is so small or so specific and it's not realistic to the populations that you're serving, then that ROI doesn't really mean anything," he said. "It's just math."
Personify Health's own platform data reveals $60 in savings for previously unconnected-to-care individuals, and $88 in savings when those individuals complete a preventative visit in the following year - figures Liebowitz described as meaningful reinvestment budget for mid-market employers facing tight margins.
Looking ahead, Liebowitz expressed strong conviction that artificial intelligence and faster data processing will remove barriers to healthcare access in ways that were not possible two or three years ago.
He pointed to AI primary care physician platforms and consumer-directed health record tools - referencing platforms including BeWell and Datavant - as examples of connected care experiences now becoming possible.
One area he highlighted is consumer-directed, real-time access to health records. Employer transparency fears - concerns among employees that their employer will see their health data - have historically suppressed engagement with wellbeing platforms.
Tools that allow individuals to control and leverage their own records, he argued, offer a path around that barrier. "Those are the connected care experiences I think are really starting to accelerate what's possible," he said.
Asked what he sees as the single biggest threat to the traditional benefits brokerage model, Liebowitz cited a combination of alternative payment models, potential disruption from large carriers, pay-for-play fatigue, and the rise of technology startups able to deliver claims-based trend reports directly to employers - at lower cost than traditional broker services have historically charged.
"How do brokers operate in this new reality and deliver even more actionable insights to the populations that they serve?" he said.
His closing challenge to employers and brokers alike was to reframe the entire value proposition of wellbeing around cost avoidance - engaging populations before costs occur, rather than managing claims after the fact. "If we need to reverse trend, we have to start stopping trend," he said. "And the best way to stop trend is to avoid those downstream costs."
Year-over-year trend reduction, Liebowitz argued, is the ROI metric the industry must learn to embrace even when it is harder to quantify than a procedure cost avoided. "That's really where I feel we're going to be able to have the biggest impact."
