As the cost of health care continues to rise, health insurance companies are continually trying to develop new products and services that aim to control these costs.
Premiums as well as member out-of-pocket costs are directly affected by the decisions that consumers make. By encouraging consumers to become more aware of how and where they access services, health insurance companies anticipate savings for both the employer and the employee. This education, along with innovative plan designs that shift more cost-sharing to the consumer, can aid in lowering costs and making consumers more aware of the impact of their decisions, says Marty Hauser, president of SummaCare, Inc.
“Insurance companies are looking at innovative ways of keeping costs down by getting consumers to better understand their health care choices and the cost of those choices,” says Hauser.
Smart Business spoke with Hauser about current trends in health insurance plan design, how the design of a plan can impact cost and how to decide which plan is right for your company.
What are some current trends in health insurance plan design?
One of the biggest trends is a move toward consumer-directed health plans. These plans feature higher deductibles than traditional health plans and are often paired with Health Savings Accounts, Flexible Spending Accounts or Health Reimbursement Arrangements. By pairing a consumer-directed health plan with a pre-tax account, employees can experience tax savings on the money that is set aside to cover deductible expenses.
The goal of these plans is not only to shift some of the costs to the employee but to also get employees to take more responsibility for their own health care. In general, if someone has to pay out-of-pocket for care, they are more likely to make more educated decisions and seek care appropriately. In addition, insurance plans are promoting wellness and online tools that provide information needed to help members make more informed decisions about their care.
Proponents of such plans say these options will help make employees more conscious about their health care consumption and use those services more responsibly. As employers and employees take on higher deductibles in exchange for lower premiums, they will be more likely to seek the right care at the right time and consume less unnecessary services — as they have to pay for more of those services out-of-pocket.
There is some concern, however, that consumers will delay seeking care or simply forgo it altogether as a result of an inability to pay the higher deductibles associated with these plans. This is why access to information about things such as benefits, wellness and where to seek care is key.
