Employees Will Pay More in 2011 for Healthcare

article top

BY EMILY P. WALKER — Employees may have to pay more for their healthcare expenses as large businesses make changes to their employee healthcare plans in order to comply with the healthcare reform law, according to a new report.

The report was released Wednesday by the National Business Group on Health (NBGH), which represents large employers on healthcare issues. The group surveyed 72 large employers representing about 3.7 million employees, and asked about medical claims costs for 2010 and projected claims costs for 2011.


The findings showed that about 63% of businesses plan to make employees pay a higher percentage of their premium costs in 2011. In addition, 46% will increase out-of-pocket maximums, while 44% will increase in-network deductibles.

As a result of those higher costs to patients, providers may see patients start asking more questions about the necessity of some procedures, NBGH president Helen Darling told reporters Wednesday.

“What we hope, and we do see evidence of this, is that people will be asking tougher questions of what’s being done for or to them,” she said. “If the provider says, ‘We have to do an MRI,’ and the patient asks, ‘What will that do for my treatment?’ and the provider says, ‘Nothing, but we want to have additional information,’ then the patient may say, ‘Then I don’t want it.'”

The companies surveyed projected that the cost of providing healthcare benefits to their employees will rise an average of about 9% in 2011, which is about 2 percentage points higher than the 7% average increase for 2010.

About 1 percentage point of next year’s increase comes from changes mandated under the Patient Protection and Affordable Care Act (PPACA), according to Darling.

In order to comply with the new law, employers are making a number of tweaks to the healthcare plans they will offer employees in 2010. For instance, 70% of employers are removing lifetime dollar limits on their employee’s plans; 26% are removing annual limits; 40% are changing specific benefits; and 13% are removing preexisting condition exclusions for dependent children under age 19.

“As large employers know, we’re in the middle of a transformation in how healthcare is financed and delivered in this country,” Darling said.

About 53% of employers were still planning on making changes to their health plan designs for 2011, the report found. However, 19% of employers were scaling back the changes they planned to make, and 19% had decided to make no changes.

The NBGH releases its report annually to help large employers anticipate what they will spend on healthcare costs for employees in the upcoming year.

A popular change for next year is that more companies will be offering wellness programs and more will foot the bill for preventive health services, such as cancer screenings. Between 85% and 95% of health plans offered by the surveyed employers in 2011 will cover 100% of preventive services with no deductible and no cost-sharing.

Companies also said they plan to offer more “consumer-directed health plans,” which include plans with high deductibles that are linked to tax-free health savings accounts.

Emily P. Walker is a Washington Correspondent for MedPage Today