Tag Archives: health plan

Employers Continue Their Cost-Shifting to Workers

With the news focused on Affordable Care Act (ACA) health insurance plans, it is often forgotten that nearly half (49%)  of  people under 65 receive their health insurance coverage from their employers or are covered by their spouse’s plan.

Patients, even those with employer-sponsored health plans, may face another condition after they are discharged from a hospital stay: acute sticker shock.

Out-of-pocket hospitalization costs rose 37% from 2009 to 2013, with the average patient paying more than $1,000 per hospital visit, according to a study conducted by the University of Michigan and published in JAMA Internal Medicine.

The survey, which was conducted before many of the Obamacare provisions were in place, including the 2014 health insurance marketplaces, examined 7.3 million hospital stays from 2009 to 2013, using data from three of the largest insurers: Aetna, United Healthcare and Humana.

Driven by an 86% rise in deductibles and a 33% increase in coinsurance — the part of the hospital bill that patients are expected to pay —out-of-pocket (OOP) costs rose faster than health insurance premiums. Annually, OOP spending increased 6.5%. In contrast, health insurance premiums increased 5.1%.

The data demonstrate that employers were shifting more costs to patients, according to Emily Adrion, lead author of the study. About 85% of health insurance benefit packages required coinsurance for inpatient hospitalizations, in addition to meeting an annual deductible. Patients with individual plans paid more than $1,800 on average, the researchers found. In contrast, those with consumer-directed plans — high deductible policies paired with health savings accounts (HSA) —OOP hospital costs topped $1,200.

Beware of Out-of-Network PPO Providers

Insurers continue to look for ways to control costs. While using the term “consumer-driven,” many of the changes are not in the best interests of consumers. One technique that continues to grow is the creation of smaller networks of doctors and hospitals. Employers enjoy lower premiums from insurers, but workers are challenged with reduced access to providers.

To make matters worse, many in-network facilities contract Continue reading Beware of Out-of-Network PPO Providers