Job-Based Health Insurance: Costs Climb At A Moderate Pace

Claxton, Gary; DiJulio, Bianca; Whitmore, Heidi; Pickreign, Jeremy; McHugh, Megan; Finder, Benjamin; Osei-Anto, Awo

doi:10.1377/hlthaff.28.6.w1002

Cited by 24 publications

(23 citation statements)

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“…This is partly a result of employers' greater willingness to pass on more of the increases in health costs to employees through higher cost sharing. 15 Although growth in out-of-pocket spending has historically been lower than growth in private health insurance spending, the two are expected to grow at roughly 6.0 percent for the second half of the projection period because of projected continuing increases in cost sharing. For private payers, hospital spending growth is projected to have increased from a twelve-year low of 2.3 percent in 2008 to 3.1 percent in 2009.…”

Section: Payer Outlookmentioning

confidence: 99%

Health Spending Projections Through 2019: The Recession’s Impact Continues

Truffer

Keehan²,

Smith³

et al. 2010

Health Affairs

159

104

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The economic recession and rising unemployment-plus changing demographics and baby boomers aging into Medicare-are among the factors expected to influence health spending during 2009-2019. In 2009 the health share of gross domestic product (GDP) is expected to have increased 1.1 percentage points to 17.3 percent-the largest single-year increase since 1960. Average public spending growth rates for hospital, physician and clinical services, and prescription drugs are expected to exceed private spending growth in the first four years of the projections. As a result, public spending is projected to account for more than half of all U.S. health care spending by 2012.

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Section: Payer Outlookmentioning

confidence: 99%

Health Spending Projections Through 2019: The Recession’s Impact Continues

Truffer

Keehan²,

Smith³

et al. 2010

Health Affairs

159

104

View full text Add to dashboard Cite

show abstract

“…(1) The financial burden on families, due to out-of-pocket health care expenses and premiums, has become more prevalent. (2, 3) Vulnerable groups such as those with chronic conditions or low incomes may be at particular risk.…”

mentioning

confidence: 99%

Nearly Half Of Families In High-Deductible Health Plans Whose Members Have Chronic Conditions Face Substantial Financial Burden

Galbraith

Ross‐Degnan²,

Soumerai

et al. 2011

Health Affairs

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High-deductible health plans – typically with deductibles of at least $1,000 per individual and $2,000 per family -- require greater enrollee cost sharing than traditional plans. But they also may provide more affordable premiums and may be the lowest-cost, or only, coverage option for many families with members who are chronically ill. We surveyed families with chronic conditions in high-deductible plans and families in traditional plans to compare health care-related financial burden – such as experiencing difficulty paying medical or basic bills or having to set up payment plans. Almost half (48 percent) of the families with chronic conditions in high-deductible plans reported health care-related financial burden, compared to a fifth of families (21 percent) in traditional plans. Almost twice as many lower-income families in high-deductible plans spent more than 3 percent of income on health care expenses as lower-income families in traditional plans (53 percent versus 29 percent). As health reform efforts advance, policy makers must consider how to modify high-deductible plans to reduce the financial burden for families with chronic conditions.

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“…1 One way in which a growing number of families are facing higher levels of cost-sharing for health care is enrollment in high-deductible health plans (HDHPs). 2 These plans, which feature annual deductibles of at least $1000per individual and at least $2000 per family before most services are covered, seek to encourage patients to become more cost-effective consumers of health care and frequently offer lower premiums than other types of health insurance.…”

mentioning

confidence: 99%

Health Care Use and Decision Making Among Lower-Income Families in High-Deductible Health Plans

Kullgren¹

2010

Arch Intern Med

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Background: Lower-income families may face unique challenges in high-deductible health plans (HDHPs). Methods: We administered a cross-sectional survey to a stratified random sample of families in a New England health plan’s HDHP with ≥$500 in annualized out-of-pocket expenditures. Lower-income families were defined as having incomes < 300% FPL. Primary outcomes were cost-related delayed or foregone care, difficulty understanding plans, unexpected costs, information-seeking, and likelihood of asking their physician about hypothetical recommended services subject to the plan deductible. Multivariatelogistic regression was used to control for potential confounders of associations between income group and primary outcomes. Results: Lower-income families (n = 141) were more likely than higher-income families (n = 273) to report cost-related delayed or foregone care (57% vs. 42%, adjusted odds ratio (AOR) 1.81 [95% CI, 1.15-2.83]). There were no differences in plan understanding, unexpected costs, or information-seeking by income. Lower-income families were more likely than others to say they would ask their physician about a $100 blood test (79% vs. 63%, AOR 1.97 [95% CI, 1.18-3.28]) or a $1000 screening colonoscopy (89% vs. 80%,AOR 2.04 [95% CI, 1.06-3.93]) subject to the plan deductible. Conclusions: Lower-income families with out-of-pocket expenditures in an HDHP were more likely than higher-income families to report cost-related delayed or foregone care but did not report more difficulty understanding or using their plans, and mightbe more likely to question services requiring out-of-pocket expenditures. Policymakers and physicians should consider focused monitoring and benefit design modifications to support lower-income families in HDHPs.

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Job-Based Health Insurance: Costs Climb At A Moderate Pace

Cited by 24 publications

References 0 publications

Health Spending Projections Through 2019: The Recession’s Impact Continues

Health Spending Projections Through 2019: The Recession’s Impact Continues

Nearly Half Of Families In High-Deductible Health Plans Whose Members Have Chronic Conditions Face Substantial Financial Burden

Health Care Use and Decision Making Among Lower-Income Families in High-Deductible Health Plans

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