Report predicts health care spending will rise

New York TimesJune 24, 2014 

Growth in health care spending is expected to tick upward next year, in part because consumers who delayed treatment during the economic downturn are now seeking care they postponed, according to a report released Tuesday.

The report, from PricewaterhouseCoopers’ Health Research Institute, forecasts medical cost growth of 6.8 percent overall in 2015, compared with the institute’s estimate of 6.5 percent for this year.

The projected increase is modest compared with the double-digit annual increases in medical inflation commonly seen before the economic downturn. But the rate of growth had been slowing in the past five years, so the upward shift is worth noting, said Ceci Connolly, managing director of the institute, the research arm of PricewaterhouseCoopers’ health consulting practice.

This so-called medical cost trend is the projected change in the cost to treat patients from one year to the next, and it’s a major factor used to determine plan premiums. The analysis measures spending growth in the employer-based health plan market, which covers about 150 million people. The forecast reflects the cost of services, as well as the amount of services used.

Now that the economy has improved, Connolly said, people are better able to afford treatments.

“Folks who postponed some services – some elective, some more serious – are going ahead and taking care of it,” she said.

Typically, employers adjust their health plan offerings in response to the cost trend, such as by increasing employees’ deductibles – the amount you pay before insurance coverage kicks in – or narrowing the network of doctors in the plan. So the net increase, after those changes are taken into account, is predicted to be about 4.8 percent.

“It probably means some additional cost shifted to individuals,” Connolly said.

Some employers already offer a high-deductible health plan as the only option for employees, and nearly half say they are considering making it the sole option in the next three years, according to the report. That is forcing consumers to pay more attention to pricing when they seek care. The institute’s research found that in 2013, roughly half of consumers who shopped for health care called around to different providers for prices, though that information is still hard to come by in many cases.

“This is a big pressure point in health care,” Connolly said.

Companies like Castlight Health, which analyzes employer claims data to help consumers compare treatment costs, are beginning to make comparative cost information available to consumers who have health insurance through their employers. Castlight recently analyzed the in-network cost of different services – including a basic battery of lab tests and a primary care visit – and found wide variations in cost within the same market.

Other initiatives aim to offer health care cost comparisons for all consumers, even if they lack coverage. The Health Care Cost Institute, a nonprofit, is working with big private insurers to provide free online information about the cost and quality of medical care for consumers; the site is scheduled to debut early next year.

Here are some questions about health costs:

Q: How can I help rein in my health care costs?

A: Regardless of what sort of coverage you have – and even if you lack health insurance – establishing a relationship with a primary care physician is a good first step, advises Dr. Jennifer Schneider, vice president of strategic analytics for Castlight Health. Primary care is less expensive than treatment by a specialist, and subsequent visits are usually less than your first visit, even if it’s for a new problem.

Q: How can I save money on lab tests?

A: Just as you can take a prescription to your preferred pharmacy, you can ask for a written order for laboratory tests and take it to the location of your choice, Schneider said. National chains may offer lower prices than hospital-based labs, since they benefit from large volumes of patients. Similarly, free-standing imaging centers may offer less expensive X-rays and CT scans.

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