PWC made a pretty big splash yesterday with its projection that medical costs will rise at a faster rate next year than they have in the recent past. The story was picked up by major media and I was on TV last night to discuss it on Al Jazeera’s Real Money with Ali Velshi.
In truth, the story is not so dramatic. The PWC report focuses only on larger employers. Costs are expected to rise around 6.8 percent (versus 6.5 percent in 2014) and most employers are responding similarly to how they have for the past several years: shifting more costs to employees, implementing high deductible health plans, and spending money on wellness programs. These approaches are surprisingly unimaginative and not likely to be terribly effective.
High deductible plans cause patients to be conscious about the first couple or few thousand dollars of costs. After that, they don’t really care since they’ve reached their out-of-pocket max. And high deductible plans are harsh on lower income employees who have a hard time paying the first dollars out of pocket. Upper income employees barely notice the difference.
And wellness programs? PWC didn’t go so far as to endorse this strategy, which is a smart move to preserve their credibility. Some of these programs are nice benefits but it’s awfully hard to find one that is going to reduce medical costs.
What would work better? How about offering employees plans that reward them financially for choosing lower cost, high quality providers?
Even if employers are paying more, things are not necessarily so dire for those buying insurance in the individual market. Average premiums are likely to rise for 2015, and the plans with the biggest market share are raising premiums the most. But thanks to the Affordable Care Act consumers are now dealing with a competitive market in insurance. As long as they are willing to switch plans, in many cases they’ll actually be able to reduce premiums. We’ll see in a few months just how savvy exchange shoppers are.
—–June 25, 2014