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Segal: Health Plans Beat Cost Expectations

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Health care costs continued to climb in 2010, but not nearly as quickly as carriers and plan administrators had predicted.

Analysts at a unit of the Segal Group Inc., New York, make that observation in a report on 2012 health plan cost trends based on a survey of managed care organizations, health insurers, pharmacy benefit managers and independent plan administrators.

A health plan cost trend figure includes the factors that affect the underlying cost of health care, such as price inflation, utilization changes, changes in technology, and changes in government benefits requirements.

Survey participants are predicting that the trend for preferred provider organization (PPO) plans that include prescription coverage but allow open access to specialists will fall to 9.5% in 2012, from a projected rate of 10.7% this year.

The trend for high-deductible health plans will fall to 9.8%, from 11.2%, according to the survey participants.

But the analysts also looked at the accuracy of the predictions participants made for the 2010 survey.

For 2010, participants were predicting a trend of 10.8% for open-access PPO plans and a trend of 11.6% for high-deductible health plans.

The actual 2010 trends were just 7.6% for open-access PPO plans and 8.6% for high-deductible plans.

“Historically, forecasts are generally higher than the actual experience,” the analysts write.

In 2010, the actual trends turned out to be the lowest recorded in at least 10 years for all types of plans analyzed.

Projected trends came close to the actual trends in 2008 and 2009 before widening dramatically in 2010, the analysts say.

“Some experts have suggested that the health care reform debate has created a temporary sentinel effect on health care providers to dampen price increases,” the analysts say. “In addition, the weak economy may have also played a role in reducing utilization rates of medical treatments and services to the extent that consumers were cautious about their health care spending.”

Lower utilization could lead to problems in the future if use of care fell because workers were putting off getting preventive care, the analysts warn.

Other Segal study coverage from National Underwriter Life & Health:


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