As healthcare reform continues to unfold in 2015 and beyond, providers, consumers, and insurance companies will continue to adapt. While most agree that the system was not previously and still is not perfect, what’s tricky to find a consensus on is how to improve things within such a complicated, entrenched system.
Health Leaders magazine, in partnership with Truven Health Analytics, recently provided a Fact File that provides an interesting breakdown of health insurance cost trends in the face of healthcare reform and, in turn, as employers attempt to reduce health insurance cost trends.
“By taking a data-driven approach, payers can manage costs and, ultimately, make their benefit programs sustainable in the context of healthcare reform. They can also maximize opportunities to improve population health and productivity and optimize the delivery of care,” reads the Fact File titled, Trends in Health Insurance Costs.
The information is broken down in terms of:
- Medical and Pharmacy Out-of-Pocket Costs: Combined, these out-of-pocket costs increased from $695 per member per year in 2012 to $734 in 2013 (a 5.7% increase). Medical alone increased 8.4% and pharmacy alone decreased 4% (the decrease is attributed to a shift to generics).
- Specialty Pharmacy: This sector saw continued growth, with an overall increase in cost of 23.1% in 2013.
- Trends in Medical and Pharmacy Claims Costs: At the current rate, these costs are on track to have increased by nearly 45% over the past nine years.
- Inpatient and Outpatient Costs: In addition to several factors at play, cost increases here seem driven by price increases and changes in admission types, while average length of stay remained steady. Outpatient services trend upwards.
- Preventative Screening Compliance
- Americans’ General Health
This data can be very interesting to hospital administration and healthcare professionals, in terms of knowing a bit more about the population you’re serving and the health insurance costs trends relevant to the care of each individual.
Click here to see the Fact File in full.