A survey by the National Business Group on Health looks at large employers’ planning for 2015 health benefits. (NBGH Survey) These employers, who cover the majority of workers, expect a 6.5% increase in health costs next year, but hope that design changes may reduce that to about 5%, which, as we never tire of pointing out, will still be way ahead of either GDP growth, general inflation or wage growth. The reduction in trend will be generated by more cost-sharing with employees, pushing wellness programs, encouraging use of cost-effective providers and much greater use of CDHPs, with many companies now saying this design will be the only one they offer workers. While only 22% of firms had a CDHP only plan this year, 32% are taking that approach for 2015. Other tools favored by these large companies include over 70% providing and encouraging use of price transparency and other shopping tools and expansion of wellness programs and associated incentives. Most employers are seeking to reduce the richness of their plans to below the level where the reform law’s excise tax would kick in. Employees suffer as a result of this, but of course the reform law is going to make health care so much more affordable and better for everyone. While this category of employer is moving slowly toward use of private health insurance exchanges, the companies are dubious about exchanges ability to better engage employees and dependents or control costs. Only about a fourth of employers are currently offering a narrow network plan and most offer it as a cheaper option alongside a broader set of providers. Many have begun to use specific management techniques for specialty pharmacy, particularly for drugs covered by medical benefits. Overall, it is clear that health insurance costs continue to rise rapidly and that firms are making employees bear these higher costs.
