As an American employer, you are confronted to a massive and complex problem :
Healthcare benefit is the first choice for 35% of the workforce, and comes only second to retirement savings when looking at top 3 choices combined :
A second figure of this survey showed that 60 % of the respondent employees would prefer better benefits over take-home money ;
a third one, that working Americans trust employers most as a source for high quality health coverage…
source : American Benefits Council National Poll November 5-9 2017
A decreasing rate in premiums hikes in the last decade
Source: Keiser/HRET Survey of Employer Sponsored Health Benefits 2001-2016
Efforts deployed by employers to curb premiums , have produced results in the last decade : its increasing pace is decelerating rapidly since 2006. But we will see below that this trend in premium hikes masks opposite evolutions in volume of care on one side and evolution in prices on the other. As it appears in a 2018 study released by HCCI (Health Care Cost Institute) : prices continued to soar, in every category of health services, while utilization staggered or even declined.
A study published recently by JAMA, after comparing health care use in the U.S. with 10 other high-income countries concluded that while utilization levels did not differ, the US still overspent them by double in 2016.
So the study came to the only one possible conclusion: The biggest culprit for high premiums today is high prices. Per unit, all U.S. health care cost factors, labor, pharmaceuticals, devices and administration are much higher than those of other developed countries.
And hence, there is only one logical conclusion :”Efforts targeting utilization alone are unlikely to reduce the growth in health care spending in the U.S.”
The above mentioned study issued by the HCCI (Health Care Cost Institute) in January 2018 illustrates this reality, applied to the ESI . Based on the claims data from 3 of the most important health insurers (totaling 40 millions insured) in ESI (Employer Sponsored Insurance) and covering 2012 to 2016, its results are very clear :
in almost every type of health service, prices soared and utilization declined :
The chart presents the evolution of three different factors :
Two examples :
The conclusion we can draw is clear :
YEAR AFTER YEAR, AMERICAN EMPLOYERS PAID MORE FOR THEIR WORKFORCE TO GET LESS !
Regarding the level of utilization, this is all the more concerning, since data showed a preexisting record level of unmet care needs due to costs in the United States, especially then it is compared to similar, high developed countries, as it appears in the opposite figure.
The above mentioned HCCI’s study, is available on their site : http://www.healthcostinstitute.org/
and so are its appendix tables, and the underlying machine-readable data tables. We analysed them to produce very precise data on different items, in order to find practical solutions to your problems.
Taking the lion’s share, hospitalization costs represent 56% of your healthcare expenses
In- and outpatient, represent 56% of the total average spending in 2016, once the related costs of professionnal services provided in hospitals have been integrated (see chart below).
SURGERY saw soaring prices and sharp declining utilization
An average episode of inpatient surgery amounted to 41.702 $
presence all along the care pathway, including potential care follow-up return to home
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