This is the healthcare delivery providers, part of the Healthcare Marketplace Specialization module 5.1.3, Employers. Learning outcomes for this last lecture will be to review how employers impact healthcare delivery, so you would wonder where do the employers fit in? Now actually, if you look at this, this is an employer, this is an employer, this is an employer, this is an employer. But also the employers, for example, for large firms and manufacturing companies, have all these employees that are actually the patients. One of the biggest things how employees work with health care delivery is that they purchase insurance for their employees. So, as we've seen most of the private health insurance in the United States is purchased through employers. For many, many decades, insurance has been a benefit of employment. But also now, it is becoming an obligation for some of the employers through the federal government and legislation. Also, employers use their purchasing power, for example, if it's a large employer with many, many employees, they could use their skill to bring down the cost of insurance through the insurance plans. Also, obviously, being an employer, they have a vested interest in their employees health and productivity. Second big thing that the employers do is to educate employees around what is the total healthcare cost of the company? So, what are the premiums that the employees are paying? What are the premiums that the employers are paying? Typically, in the US, the employer pays a bigger share of the premium than the employee. Although, that is being slowly shifted over to the employees. Also, they can educate their employees about what is the employer doing to bring down the premium and the overall healthcare delivery cost. And also, they can educate the employees about what should the employees do to bring down the overall cost for their company. Another thing employers can do, and they're doing it more, and more, and more is by creating healthy working places and actually creating health for their employees. So, a lot of the employers are putting in gyms and walking paths and healthy foods, also, some employers are putting in clinics at work so that the employees do not have to leave the work to go see a physician or a nurse practitioner. Also, they are using technology, for example, tele-medicine to bring in the care at work to make it more convenient, and also to improve productivity. Finally, the employers also use sticks and carrots in their benefit plans and in their insurance plans by slowly moving the cost over to the employees in order to make the employees more accountable and more engaged in the overall healthcare costs, which as you know, is rising for all of the employers across the US. The fourth thing they do which is very important is that they influence care delivery. So, sometimes, they work directly with the healthcare delivery system, maybe partner by bringing their expertise from industry to bear. But the other key driver is they work through their third party administrator or the insurance company to bring in sticks and carrots, so that the delivery system really produces an efficient product and reduces the overall cost of care. Employers are also having a lot of new changes, either through legislation or other rules. There are new penalties now for not providing insurance coverage for their employees. Also, we've discussed that the rising cost of healthcare is making it very difficult for some employers to sustain. So, they have a vested interest in bringing this cost down. Also, when some large employers compete a on a global scale, the very high cost of insurance for the U.S. workers compared to other workers across the world is a challenge. And then, finally, they are a very critical stakeholder and a partner at the healthcare transformation table, and they can bring their heft to bear with insurance companies to really influence change in the healthcare delivery system. In summary, employers are significant influencer for healthcare delivery, they work either indirectly by working through payers or sometimes, they're directly working by engaging with the healthcare delivery providers in order to achieve the triple aim for their employees and also for the broader community.