The ongoing corporate battle to hold down health plan increases should show some results next year. But prescription drugs continue to foil attempts to truly rein in health care costs.
That is the main finding in a new health plan cost trend survey from benefits and HR consulting firm The Segal Group. It's the 18th edition of the trend survey, and Segal made no bones about the concerns raised by the trending of drug prices.
"New specialty drugs coming onto the market and price increases for brand-name drugs are the main forces driving prescription drug plan cost trends," said Edward Kaplan, Segal's national health practice leader. "Typically, less than one percent of all prescriptions are specialty drug medications, yet these drugs now account for more than 25 percent of total prescription drug cost trends. The projected specialty drug/biotech trend rate for 2015 is an exceptionally high 19.4 percent."
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This bleak forecast of prescription drug increases comes on the heels of a decrease for large plan members overall reported earlier this year by Buck Consultants. Buck said prescription drug plan increases had shown moderation in its survey, with a 9.2 percent hike this year compared to 9.9 percent in 2013.
That won't be the case next year, Segal predicted. Its respondents said they foresee "higher trend rates for all prescription drug plans," Segal said in a release.
"The trend for carve-out coverage is projected to jump from 6.3 percent in 2014 to 8.6 percent in 2015. The carve-out trend for retirees 65 and older is projected to rise from 5.7 percent in 2014 to 7.5 percent in 2015, more than twice the rate of retiree medical cost trends," Segal reported.
However, Segal's Kaplan noted that "forecasts are generally higher than actual experience, as insurers and analysts typically add margin to estimates to cover claim volatility. In 2013, actual trends for managed care plans were the lowest reported in more than 12 years."
Among other data drawn from the survey, Segal reported that HMOs could expect increases in the 6 percent range, while fee-for-service plans might see increases exceeding 10 percent. Open-access PPOs and point-of-service plans could see actual declines, from 7.9 percent this year to 7.8 percent next year, based upon the information gathered.
Asked to estimate how much out-of-pocket maximums might increase as employers adjusted for health care reform, respondents said they saw a 1 percent increase for medical plans and 1.5 percent for prescription drug plans.
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Dan Cook
Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.
