According to one KFF survey, 30% of adults avoid taking their medication as prescribed due to the cost, with another 21% of adults not filling a prescription at all. Even worse, in the face of skyrocketing prices, 47% of adults find it very or somewhat difficult to afford healthcare costs in general.
Obviously, increasing costs and their impact on patients isn’t sustainable, but what’s the solution?
Variable co-pays are gaining traction as a way to manage rising healthcare costs for both employers and employees. However, transitioning to this framework from a traditional co-pay model isn’t necessarily easy.
By proactively educating employees, providing the right tools, and continually monitoring the impact, employers can maximize the benefits of this approach while ensuring a seamless experience for all stakeholders.
What are Variable Co-Pays?
An alternative to traditional co-pay models, variable co-pays are an increasingly popular way to reduce the skyrocketing costs of medical care.
Variable co-pay model designs can be customized based on factors such as the type of service, the provider’s cost and quality rating, or the setting where care is delivered. Regardless of design, their goal remains the same: to incentivize smarter healthcare decisions by making high-value care more affordable without deductibles or coinsurance.
Some benefits of a variable co-pay model include:
- Reducing overall healthcare spending by steering members toward higher-value care
- Improving access and treatment adherence by making high-quality care more affordable
- Simplifying the member experience through clear, service-based co-pays
- Strengthening cost efficiency by applying savings automatically during claim processing
Variable co-pays can also be a strategic advantage for employers looking to control healthcare costs while supporting their workforce.
By implementing a well-structured variable co-pay model, employers create a win-win situation: lower costs for their business and improved healthcare affordability for employees.
How Employers Can Manage Variable Co-Pays
As healthcare costs climb, employers need smarter ways to deliver value without breaking the budget. Variable co-pay models offer a flexible, cost-effective solution — and the key to success is helping employees understand the change.
Communicate the change effectively.
By using clear, proactive, and multichannel communication strategies that detail how pricing works with the health plan and what it means for their employees, employers can effectively communicate the shift from a traditional co-pay to a variable co-pay model.
First, explain the whys: Make sure employees understand that this approach helps balance costs, ensures access to necessary medications, and optimizes healthcare spending.
In addition to sending an initial email regarding the change, employers should host a dedicated webpage about the new structure and cost examples in their benefits portals. HR and benefits personnel must be well-versed in the new system and well-equipped to handle employee questions and concerns.
Throughout this transition, it’s crucial to reinforce the benefits employees may experience, including greater cost savings, and to foster a culture of understanding and empathy.
Provide supportive tools.
Supportive tools — such as cost transparency solutions, pharmacy benefit services, and care navigators — can give employees confidence in their healthcare and empower them to make informed decisions.
Pharmacy programs, such as Bluebook Rx from Valenz, focus on a few core strategies to reduce costs, build long-term savings, and deliver tailored support to members. In the case of Bluebook Rx, these are:
- Integrated Health Management (IHM)/GLP-1 Savings Strategy Program: With prescription drug prices on the rise, this savings strategy offers a smarter, low-cost, bundled solution that significantly lowers GLP-1 pharmacy expenses, creating fixed healthcare costs and improving access to essential medications.
- Coupons: Intelligent application of manufacturer and third-party coupons reduces out-of-pocket costs for members and overall plan spend, helping both employers and members capture hidden savings without sacrificing access.
For additional support, Bluebook Rx proactively engages members with personalized pharmacy savings opportunities. The concierge support team is ready to help members understand the alternatives, and work with the member and provider to ensure the member has access to the most cost-effective options.
Monitor the impact and make adjustments.
Monitoring the impact of a variable co-pay model is essential to ensuring a successful transition for employees. Regularly assessing employee satisfaction and cost trends will enable you to fine-tune your approach and adjust as needed.
Gathering feedback through surveys, HR check-ins, and benefits usage data can provide valuable insights into how well the new model is working. If gaps or concerns arise, refine your strategy as needed — for example, with enhanced communication or additional healthcare tools.
A responsive, data-driven approach to the variable co-pay model ensures that employees feel supported while maintaining long-term savings and improved outcomes for all.
Maximize Savings, Improve Employee Health
By lowering out-of-pocket costs and steering care toward high-value providers, a variable co-pay model can drive measurable savings for your organization and your employees. Just as important, this model helps improve health outcomes by making essential care and medications more affordable — supporting strong, vigorous, and healthy lifestyles among a more engaged workforce.
Connect with us today and learn how to control healthcare costs with innovative health plan solutions from Valenz.
