Employers shifted more out-of-pocket health costs to employees in 2008 while holding benefit cost increases to about 6%, according to Mercer, the benefits consulting firm.
The most striking single piece of data that came out of Mercer’s annual National Survey of Employer-Sponsored Health Plans is that the median deductible for employees enrolled in a PPO reached $1,000 for the first time, after 7 years of hanging at $500. PPOs cover 69% of all enrolled employees in the U.S. (= 2 in 3 commercially insured Americans).
Blaine Bos of Mercer points out that raising the deductible is one way for employers to stem cost increases without “taking more out of every employee’s paycheck,” he says in the survey report.
These data are part of a pre-view of Mercer’s full survey will be published in March.
Health Populi’s Hot Points: The wild card in the Mercer survey is how global economic decline will impact 2009. Mercer raises the historical trend that during a recession, health utilization increases. If covered employees worry about losing their jobs, they “pre-demand” health services they might otherwise wait to receive.
As more Americans grow concerned about the threat of job losses — which is a natural worry given the daily announcements of job cuts by firms, large and small alike — Americans could increase their use of health services in next few months.
On the other hand, a $1,000 deductible could provide a rationing tool on the part of employers who want to slow utilization trends.
Observing job-worried enrollees‘ health care utilization trends in the next couple of quarters will be important to understanding the role of the new $1,000 deductible and its impact on Americans’ health-rationing.

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