Health care premiums for large employers will increase 15 percent on average in 2003 — the biggest year-over-year jump since Towers Perrin began conducting the survey in 1989.

"Employees will be paying more out-of-pocket this year," says Ron Fontanetta, a Towers Perrin principal. "Cost sharing will come in the form of increased monthly contributions, as well as higher deductibles and copayments."

NOTE: There were 268 responses to the survey of mostly Fortune 1000 companies, conducted in August and September 2002.


Average cost increases: 1993-2003

Great year for some forms of health insurance

Meanwhile, the health insurance industry, as a whole, had a great year last year, according to Weiss Ratings. The companies recorded a 25 percent increase in profits for 2001, earning $4.1 billion for the year, compared to $3.3 billion for 2000. In the map below, Weiss Ratings' estimates of industry profits by state are combined with state population estimates to reveal where insurers were most successful and where they found a more challenging business climate.

HMOs are the exception

The nation's 573 HMOs did not fare so well, posting a 6.87 percent decline, from $1.08 billion in 2000 to $1.01 billion in 2001. It will be interesting to see if consumers will be able to differentiate between HMOs and the rest of the industry when, as Towers Perrin's Fontanetta predicts, they'll be asked to pony up more of their own money.


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There’s a lot more going on in health care than mergers (Aetna-Humana, Anthem-Cigna) creating huge players. Hundreds of insurers operate in 50 different states. Self-insured employers, ACA public exchanges, Medicare Advantage, and Medicaid managed care plans crowd an increasingly complex market.

Major health care players are determined to make health information exchanges (HIEs) work. The push toward value-based payment alone almost guarantees that HIEs will be tweaked, poked, prodded, and overhauled until they deliver on their promise. The goal: straight talk from and among tech systems.

They bring a different mindset. They’re willing to work in teams and focus on the sort of evidence-based medicine that can guide health care’s transformation into a system based on value. One question: How well will this new generation of data-driven MDs deal with patients?

The surge of new MS treatments have been for the relapsing-remitting form of the disease. There’s hope for sufferers of a different form of MS. By homing in on CD20-positive B cells, ocrelizumab is able to knock them out and other aberrant B cells circulating in the bloodstream.

A flood of tests have insurers ramping up prior authorization and utilization review. Information overload is a problem. As doctors struggle to keep up, health plans need to get ahead of the development of the technology in order to successfully manage genetic testing appropriately.

Having the data is one thing. Knowing how to use it is another. Applying its computational power to the data, a company called RowdMap puts providers into high-, medium-, and low-value buckets compared with peers in their markets, using specific benchmarks to show why outliers differ from the norm.
Competition among manufacturers, industry consolidation, and capitalization on me-too drugs are cranking up generic and branded drug prices. This increase has compelled PBMs, health plan sponsors, and retail pharmacies to find novel ways to turn a profit, often at the expense of the consumer.
The development of recombinant DNA and other technologies has added a new dimension to care. These medications have revolutionized the treatment of rheumatoid arthritis and many of the other 80 or so autoimmune diseases. But they can be budget busters and have a tricky side effect profile.

Shelley Slade
Vogel, Slade & Goldstein

Hub programs have emerged as a profitable new line of business in the sales and distribution side of the pharmaceutical industry that has got more than its fair share of wheeling and dealing. But they spell trouble if they spark collusion, threaten patients, or waste federal dollars.

More companies are self-insuring—and it’s not just large employers that are striking out on their own. The percentage of employers who fully self-insure increased by 44% in 1999 to 63% in 2015. Self-insurance may give employers more control over benefit packages, and stop-loss protects them against uncapped liability.