Practice is making perfect with regard to health plan cost containment by employers.

Employers no longer struggle with where to begin to make their health plans more cost effective while improving employee health. 

Plan design changes based on research and trial and error have, over the past five years, teased out the areas of highest opportunity.

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This  is confirmed by research from best practices consultants CEB and DirectPath, both of which have expertise in advising corporations on managing health care costs.

The two teamed up to study the health plans of 750 major employers. The result: A list of the top 10 trends in health care strategies.

The 10 can be loosely grouped into three categories: strategies to shift toward  more cost-sharing; to encourage employees to use standard care over specialized care; and to integrate successful non-traditional health care options into plans.

Here are the 10 trends.

Photo: Getty

1. Rising deductibles

Regardless  of plan type, employers are continuing to increase individual and family member deductibles.

Of the plans reviewed, individual deductibles rose by 40 percent this year and, for family members, by 17 percent.

Photo: Getty

2. Further cost-shifting

In addition to increasing deductibles generally, employers are offering more high-deductible plans to members that ask them to take on other costs that management had traditionally borne in exchange for lower premiums.

These HDHP have become more prevalent in the last few years; the increase in their offering was minimal in 2016.

Photo: Getty

3. Out-of-pocket max

One area that didn't change much in 2016 was out-of-pocket costs. 

Companies offering plans with comparatively high OOP costs barely rose compared to 2015.

Photo: Getty

4. Plan surcharges

Unlike high out-of-pocket plans, plans with surcharges leapt ahead this year. 

Most include tobacco and spousal coverage surcharges.

One in five plans include a tobacco surcharge, and a quarter said they will add a tobacco surcharge. Just 12 percent said they had spousal surcharges, but nearly 30 percent intend to include them soon.

Photo: AP

5. Outpatient surgery

To encourage plan members to address surgical matters further upstream, employers are reducing the copay for outpatient survey and raising it for inpatient.

Outpatient copays fell an average of 25 percent, while inpatient rose 68 percent.

Photo: AP

6. Emergency room copays

Employers want members to think about going to the emergency room as a last resort, and so are raising copays by an average of 22 percent.

Meantime, urgent care copays remained unchanged.

Photo: Getty

7. Prescription drug copays

No surprise here: Employers,  like everyone else, are struggling to find the sweet spot with specialty pharmaceutical cost control. 

So far, employers are taking the hit, as specialty drugs rose by nearly 50 percent this year.

Photo: AP

8. Maternity cost control

Employers are teasing out the maternity costs they don't have to automatically fully cover under terms of the Patient Protection and Affordable Care Act.

Among the ones employers are targeting for higher out-of-pocket copays: in-hospital delivery, with the copay up an average of 35 percent in 2016.

Photo: AP

9. Telemedicine

Employers aren't yet sure what virtual care's potential for cost control is, but they're going to find out.

Almost two-thirds in this study say they will include more telemedical services by 2018. More than a third already offer some virtual medical services.

Photo: AP

10. Wellness incentives

It's become an old standby now, and as employers gather more experience with wellness plans, they're finding which incentives work, and which ones don't.

About half the respondents to this survey offer incentives with their wellness plans, ranging in value from $52 to $1,600, another sign that there's yet more to be learned.

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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.