Patient cost-sharing on the rise: results from the benefit design index

The relationship between healthcare insurers and employers plays a critical role today in decisions about benefit design, cost-sharing, and even the coverage of individual products and services. To better understand how these 2 stakeholders interact in the creation of healthcare benefit design, the Zitter Group conducted a large national study of insurer-employer relationship.

This study is based on a primary web-based survey with 100 top decision makers in large national and important regional commercial managed care plans, and a similar survey of 100 employers and employer benefit consultants, including medical directors and benefit decision makers. This article reviews the results of this research, especially in relation to insurer and employer opinions on patient cost-sharing.

Findings from this study show that cost-shifting remains the prevailing cost-containment strategy used by insurers and employers. These stakeholders expect that additional cost-shifting will have minimal impact on patient health outcomes.

Despite accumulating evidence that cost-shifting leads to undesirable health and cost consequences and has largely failed to slow health cost growth, employers and insurers will likely continue to rely on this modality as their primary cost-containment strategy.