2017 Employer Health Benefits Survey

This article appeared on Kaiser Family Foundation on September 19, 2017.

Employer-sponsored insurance covers over half of the nonelderly population; approximately 151 million non-elderly people in total.1 To provide current information about employer-sponsored health benefits, the Kaiser Family Foundation (Kaiser) and the Health Research & Educational Trust (HRET) conduct an annual survey of private and nonfederal public employers with three or more workers. This is the nineteenth Kaiser/HRET survey and reflects employer-sponsored health benefits in 2017.

HEALTH INSURANCE PREMIUMS AND WORKER CONTRIBUTIONS

In 2017, the average annual premiums for employer-sponsored health insurance are $6,690 for single coverage and $18,764 for family coverage [Figure A]. The average single premium increased 4% and the average family premium increased 3% in 2017. Workers’ wages increased 2.3% and inflation increased 2.2% over the last year.2 The average premium for family coverage is lower for covered workers in small firms (3-199 workers) than for workers in large firms (200 or more workers) ($17,615 vs. $19,235).

Premiums for family coverage have increased 19% since 2012 and 55% since 2007. Average premiums for high-deductible health plans with a savings option (HDHP/SOs) are considerably lower than the overall average for all plan types for both single and family coverage, at $6,024 and $17,581, respectively [Figure A]. These premiums do not include any firm contributions to workers’ health savings accounts or health reimbursement arrangements.

Premiums vary significantly around the averages for both single and family coverage, reflecting differences in health care costs and compensation decisions across regions and industries. Seventeen percent of covered workers are in plans with an annual total premium for family coverage of at least $22,517 (120% or more of the average family premium), and 21% of covered workers are in plans where the family premium is less than $15,011 (less than 80% of the average family premium).

Most covered workers make a contribution toward the cost of the premium for their coverage. On average, covered workers contribute 18% of the premium for single coverage and 31% of the premium for family coverage. Workers in small firms contribute a higher average percentage of the premium for family coverage than workers in large firms (39% vs. 28%).

Covered workers in firms with a relatively high percentage of lower-wage workers (at least 35% of workers earn $24,000 a year or less) contribute higher percentages of the premium for single (23%) and family (37%) coverage than workers in firms with a smaller share of lower-wage workers (18% and 31%, respectively).3

As with total premiums, the share of the premium contributed by workers varies considerably. For single coverage, 14% of covered workers are in plans that do not require them to make a contribution, 60% are in plans that require a contribution of 25% or less of the total premium, and 2% are in plans that require a contribution of more than half of the premium. For family coverage, 3% of covered workers are in plans that do not require them to make a contribution, 44% are in a plan that requires a contribution of 25% or less of the total premium, and 16% are in plans that require more than half of the premium. Covered workers in small firms are more likely than covered workers in large firms to be in a plan that requires the worker to contribute more than 50% of the total family premium (36% vs. 8%).

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People in high-deductible plans are not acting like consumers after all

The article below was published on November 28, 2017 by Healthcare Finance, written by Jeff Lagasse.

Despite growth of these plans, price shopping, cost discussions with doctors are rarely happening, researchers find.

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Photo Source: Healthcare Finance

Though more Americans are paying thousands in deductibles before the insurance coverage kicks in, a new study suggests that despite the rise in these plans, most who have them aren’t saving, shopping around for better prices, talking to their doctors about costs, or making other consumer-type moves.

And even when they do, they only get help about half the time, according to the new study published in JAMA Internal Medicine by a team from the University of Michigan Institute for Healthcare Policy and Innovation.

With a culture of consumerism becoming ever more entrenched in American healthcare, the findings may catch the attention of hospital leaders looking to entice more consumers to utilize their services.

The research, based on a national poll of 1,637 adults under age 65 who had HDHPs for at least a year, provides new insight into the behavior of people with a type of insurance that many employers have turned to in an effort to reduce their own healthcare costs.

More than 40 percent of American adults have an HDHP, according to the Centers for Disease Control and Prevention. The plans, which require individuals to pay at least the first $1,300 of their own costs, and families the first $2,600, often are offered with a tax-protected health savings account to help people stash away money to pay for their future care needs.

The vast majority of the poll’s participants got their HDHPs through an employer, although such plans can also be bought on the Affordable Care Act individual insurance exchanges and directly from insurers. Some policymakers have championed the plans as a way of giving patients “skin in the game” when it comes to their healthcare costs.

Employers often encourage people enrolling in HDHPs to put away money for when they need it, to research costs and quality ratings at different providers and healthcare facilities, to talk with their doctors and other providers about costs, and to negotiate prices for services they need.

But the researchers, who are especially interested in the effects of HDHPs on people with chronic illnesses who can expect to have regular healthcare needs, found that many people aren’t pursuing these “consumer” behaviors. They over-sampled for people with chronic illnesses in the poll, so that 42 percent of respondents had at least one such condition.

In all, 58 percent of poll participants said they had an account to put aside money for medical expenses, including HSAs. But only 40 percent of the entire sample had actually saved any money for their future medical costs. Only 25 percent had talked to a healthcare provider about the cost of a service; 14 percent had compared prices for the same service or product, or the quality ratings for different providers. A scant 6 percent had tried to negotiate the price of a healthcare service, either in advance or after they received a bill for a service they’d received.

The poll also asked those who had engaged in consumer behaviors more questions about what they had done and what the results were. Among the 248 people who had compared prices, 61 percent had done it for prescription drugs, and only 38 percent had done it for outpatient. Just 45 percent of those who had compared prices said it had actually helped them pay less for a service.

Of the 204 people who had compared quality ratings, 71 percent had done it for an outpatient visit; meanwhile, among the 445 people who had talked to a provider about cost, two-thirds had done it for prescription medicines, but only 45 percent said that having this discussion had helped them get care they needed.

And of the 685 who had saved money for their medical care, just over half said that this practice helped them get care they needed in the past year.

The researchers concluded that healthcare providers, insurers and employers could do more to help people in HDHPs — for instance, providers could help people in HDHPs understand their possible future medical needs so they can try to save for them.

Healthcare facilities could also make prices available at the point of care so that patients and providers can talk about cost. And employers that offer HDHPs could offer more than just price information to help employees learn how to use this information in their decision making.

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