In recent years, the trend in benefit design has leaned toward plans with high deductibles and lower premiums, which shift more out-of-pocket costs to employees. The use of cost-saving strategies that control patients’ access to healthcare services, known as “utilization management” or “UM” has also increased dramatically. And formularies, the list of drugs covered by a health plan, have become more restrictive and include more pricing tiers, which can result in greater expense for employees who need certain medicines.
All this cost-shifting has helped employers keep their benefit costs under control, but what has it done to employees? According to the Kaiser Family Foundation, nearly half (46%) of insured adults report difficulty affording their healthcare out-of-pocket costs. In fact, a recent survey by Bankrate, a personal finance company, found that 56% of Americans would be unable to pay for a $1,000 emergency, such as an unexpected car repair or emergency room visit.