Benefits October 24, 2017

Most Workers Concerned About Rising Out-of-Pocket Medical Costs

More than half of Millennials struggle to pay their doctors’ bills or have an acquaintance who does.

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Sixty-three percent of Americans who have health insurance at work are worried about out-of-pocket medical costs increasing in the new year, Securian Financial Group learned in a survey. Thirty-two percent of Millennials with health insurance deductibles have had to pay an out-of-pocket expense for an injury over the past year, and 52% either are having trouble paying medical bills or know someone who is.

Forty-four percent of parents with health insurance at work have experienced a child undergoing a significant injury, with the most common—cited by 23%—involving an emergency room visit. Sixteen percent reported that a child had a broken bone, and 11% said their child had a cut that needed stitches.

“Play-related and sports injuries are common in active families with children and can mean an emergency trip to a doctor and unplanned medical costs,” says Elias Vogen, director of group insurance client relationships for Securian. “Among parents who have had a child experience a major injury, 71% paid up to $2,000 in out-of-pocket medical costs as a result of the injury, and one in 10 paid more than $5,000.”

Forty-seven percent of workers are concerned that their employer will cut back on their health insurance benefits in the coming year. This is why it is important, Vogen says, for workers to pay attention to their employer’s offerings during this year’s open-enrollment season—because there could be changes.

Securian’s findings are the result of two surveys conducted by KRC Research among 1,584 worke

Data and Research October 24, 2017

Price Inflation Again to Blame for Much of Projected Rising Health Plan Costs

Options are available, though, to mitigate the jump and provide more affordable care.

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The Segal Group’s new Health Plan Cost Trend Survey reveals that, as found by its last year’s survey, price inflation will be the main driver of projected health plan cost increases in 2018.

This will be seen most notably in prescription drugs, with projected 8.8% price inflation, and hospital services, with projected 4.6% price inflation. Compare those jumps with the projected growth in use of prescription drugs and hospital services—only 2.1% and 1.5%, respectively, Segal found.

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Yet, there are options available to mitigate the price inflation, according to Eileen Flick, senior vice president and director of health technical services at Segal in New York City. She says, “Plan sponsors should consider using alternative value-based payment approaches such as accountable care organizations and bundled payments for episodes of care. Under these payment alternatives, providers are reimbursed at a set rate for all services involved in an episode, and they are accountable for the quality of care and outcomes. We have also seen a continued push toward specialized pharmacy management and intensified pharmacy management programs.”

According to the survey, some of the price inflation results from inappropriate use of emergency rooms and urgent-care facilities, as well as from unnecessary, expensive diagnostic radiology procedures, when a simple X-ray would suffice. “Plan sponsors should ensure their plan designs properly align with the costs of care and that participants are making smart choices in order to get the right care at the right place with the right provider,” Flick says. 

 

 

 

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