Employers turn to workers to help slow health cost growth

Dr. Drew Altman, president and CEO of the Kaiser Family Foundation, said a key takeaway of the survey is that "premium growth remains strikingly low".

It's the continuation of a multiyear trend of companies passing more of the costs of employee health care back onto workers.

The average annual family premium for employer-sponsored health insurance is $18,142 this year-a 3 percent increase from the year prior, according to the Kaiser Family Foundation/Health Research & Educational Trust (HRET) 2016 Employer Health Benefits Survey.

Historically, that's not much of an increase. It also showed that the share of employers that offer health benefits, at 56% this year, remained roughly the same as last year.

State health insurance exchanges created under the new health care law are in turmoil.

Covenant Care, a Pensacola, Fla. -based hospice and home health care nonprofit, is one organization that has made the switch.

The challenge with deductibles comes when employees aren't given a choice and the plans don't make sense for the workers due to other factors, says Pauly, a professor at the Wharton School at the University of Pennsylvania.

Members of high-deductible plans paid almost a fourth of their total medical costs out of pocket versus only 14 percent for members of conventional plans.

In 2014, total annual health spending was $659 less per person in high-deductible plans, or 13 percent, than in conventional plans, according to analysis by the Health Care Cost Institute of claims for 40 million employees covered by Aetna, Humana and UnitedHealthcare.

Health risk assessments. Most large firms offering health benefits (59 percent) offer to give workers a health risk assessment that asks questions about their medical history, health status and lifestyle. Since 2011, average family premiums have increased 20 percent, more slowly than the previous five years (31 percent increase from 2006 and 2011) and more slowly than the five years before that (63 percent from 2001 to 2006).

With the continuous increases, companies like Covenant are getting creative, Altman says. Only 2 percent said they were switching full-timers to part time to make them ineligible. They try to help workers manage their chronic illnesses.

Families are paying 3.4 percent higher premiums this year for health insurance through their jobs, but deductibles are up 12 percent as employers continue shifting medical costs to employees.

Some 51% of workers face deductibles of at least $1,000 for single coverage, with the average deductible hitting $1,221. To help defray the costs of that deductible, the company offers a supplemental benefit to people once they've paid the first $500 of their deductibles, allowing them to receive up to $750 toward deductible payments.

"I would say no one goes there lightly", he says.

— Employers still pick up most of the bill for coverage. "They had to fix premium costs in some way". "The goal is to keep the rate of increase down and ensure resources are available to the sickest employees and encourage wellness for those who can prevent disease". The 2016 survey includes information on the use of incentives for employer wellness programs, plan cost-sharing as well as firm offer rate. Many insurers assumed that people on the exchanges would be about as healthy people in the small-employer market, but that was not the case, he said.

We've been so fixated on the Affordable Care Act, we've missed a gradual sea change in what health insurance is for most Americans.

A separate study released earlier this week found a markedly different pattern of health care use between people on high-deductible plans, compared with traditional plans.

  • Audrey Hill