Large employers expect health care costs to increase by about 7% next year, according to a survey by the National Business Group on Health, the Washington Post's "Wonkblog" reports (Kliff, "Wonkblog," Washington Post, 8/6).
The expected increase for 2013 is about the same as what employers projected in 2012, but lower than what employers expected in the three previous years (NBGH release, 8/6).
Survey Details
NBGH did not attribute the increase to the Affordable Care Act, though it noted that many employers are changing their health plans to comply with the law (Baker, "Healthwatch," The Hill, 8/6).
In response to the expected increase, about 60% of the 82 large employers surveyed said they will increase premiums next year (McCarthy, National Journal, 8/6). However, most respondents said workers' costs would increase by less than 5% ("Healthwatch," The Hill, 8/6)
Meanwhile, 40% of respondents said they plan to increase in-network deductibles, while 32% said they expect to increase out-of-pocket maximums (Reichard, CQ HealthBeat, 8/6).
The survey also found that for the first time since the ACA was enacted, a majority of employers said that in 2013 they would not have a health plan in "grandfather" status, which exempts the plan from certain provisions in the overhaul, such as providing no-cost preventive care services (National Journal, 8/6).
The ACA also is affecting businesses in other ways, according to the survey. For example, 94% of respondents said they would be forced to reduce limits on flexible spending accounts to $2,500 because of the ACA's limits on how much of such funds can be paid pre-tax.
In addition, nearly half of respondents said they were unsure of how they will handle the rebates under the medical-loss ratio provision in the health reform law, while 7% said they would apply the rebates to future premiums.
Employers Eyeing Wellness Programs
NBGH found that many employers plan to increase the amount of money they pay to employees to maintain healthy lifestyles or participate in a wellness program.
About half of the employers said they already use financial incentives to encourage healthy behavior or boost participation in wellness programs. The median amount employees can earn is expected to increase by about 50% in 2013, from $300 this year to $450, according to a news release (CQ HealthBeat, 8/6).
Health Exchanges Seen as Option for Current, Former Workers
About 16% of employers said they might push full-time employees to obtain coverage through the state-based health insurance exchanges created by the health reform law (National Journal, 8/6).
More respondents said they expect other populations to shift into exchanges, rather than through the benefit packages they offer ("Wonkblog," Washington Post, 8/6).
For example, more than half of respondents said retirees could find coverage in the health insurance exchanges, while 40% said former workers enrolled in COBRA could enroll through exchanges, and 35% said part-time workers might obtain coverage through the exchanges (National Journal, 8/6).
Survey Finds Increased Interest in 'Reference Pricing'
Helen Darling, president of NBGH, said the survey indicates that many employers plan to increase the use of so-called "reference pricing," under which the business pays a certain amount for a health service and workers that elect to see a physician or get a procedure that costs more than the reference point are responsible for the difference.
Darling said the practice already is common with prescription benefits (CQ HealthBeat, 8/6).