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Employers Pass the Buck on Rising Health Care Costs
Benefit Changes Include Increased Patient Cost Sharing and Less-Generous Family Coverage Policies
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ASHINGTON, D.C.Rather than dramatic health benefit overhauls, most employers have made modest changes, primarily by shifting costs to workers through larger premium contributions or higher out-of-pocket costs to fill a prescription or see a doctor, according to a study released today by the Center for Studying Health System Change (HSC).
"Despite predictions that the weak economy would spark an overhaul of health benefits, most employers have moved cautiouslybut steadilyto increase what patients have to pay," said Paul B. Ginsburg, Ph.D., president of HSC, a nonpartisan policy research organization funded principally by The Robert Wood Johnson Foundation.
"Increased patient cost sharing appears to be employers default plan, but most lack confidence that this strategy alone will provide a long-term solution to escalating health costs," Ginsburg said.
The studys findings are detailed in a new HSC Issue BriefEmployers Shift Rising Health Care Costs to Workers: No Long-Term Solution in Sight. The study is based on HSCs 2002-03 site visits to 12 nationally representative communities: Boston; Cleveland; Greenville, S.C.; Indianapolis; Lansing, Mich.; Little Rock, Ark.; Miami; northern New Jersey; Orange County, Calif.; Phoenix; Seattle; and Syracuse, N.Y.
"Most employers were unwilling to run the risk of alienating workers by curtailing their choice of physicians and hospitalsin essence, they maintained choice at a price," said HSC Research Assistant Lydia Regopoulos, coauthor of the study with HSC Senior Researcher Sally Trude, Ph.D.
Along with shifting costs to workers, some employers are promoting public insurance as an alternate source of coverage for children of their low-income employees, and many reported modifying family coverage or planning to do so, using one of two strategies: (1) changing relative premium subsidies between single and family coverage and (2) encouraging workers spouses to obtain coverage through their own employers when possible.
Employers increased patient cost sharing either by passing on a larger share of premiums to workers or by increasing copayments, deductibles and coinsurance, where patients pay a percentage of the total cost of care instead of a fixed amount.
The Center for Studying Health System Change is a nonpartisan policy research organization committed to providing objective and timely research on the nations changing health system to help inform policy makers and contribute to better health care policy. HSC, based in Washington, D.C., is funded principally by The Robert Wood Johnson Foundation and is affiliated with Mathematica Policy Research, Inc.