Jeremy Pickreign

Health Benefits In 2010: Premiums Rise Modestly, Workers Pay More Toward Coverage

Our annual analysis of health benefits contains findings from interviews of 2,046 public and private employers surveyed during January-May 2010. Average annual premiums in 2010 were

Trends In Underinsurance And The Affordability Of Employer Coverage, 2004–2007

5,049 for single coverage and

Job-Based Health Insurance: Costs Climb At A Moderate Pace

13,770 for family coverage--up 5 percent and 3 percent from 2009, respectively. Workers paid more toward premiums in 2010, and more workers are in consumer-directed plans and plans with high deductibles than in 2009. Thirty percent of firms reported that they reduced the scope of benefits or increased cost sharing because of the recession. Surprisingly, the percentage of firms offering health benefits in 2010 increased to 69 percent, up from 60 percent in 2009. The change was largely driven by a thirteen-percentage-point increase in the number of firms with three to nine workers that offered benefits (up from 46 percent in 2009 to 59 percent in 2010). The reason for this increase is unclear.

HIV Testing and Referral to Care in U.S. Hospitals Prior to 2006: Results from a National Survey

Based on simulated bill paying, this paper examines trends in comprehensiveness of coverage, out-of-pocket spending for medical services, underinsurance, and the affordability of employer-based insurance from 2004 to 2007. Data are from MarketScan medical claims and an annual survey of employer health benefits. Health plans covered slightly fewer expenses in 2007 than in 2004, but out-of-pocket spending grew more than one-third because of growth in overall health spending. For people at 200 percent of poverty, the percentage spending more than 10 percent of their income out of pocket on premiums plus services increased from 13 percent to 18 percent.

Financial protection afforded by employer-sponsored health insurance: current plan designs and high-deductible health plans.

Each year the Kaiser/HRET Survey of Employer Health Benefits takes a snapshot of the state of employee benefits in the United States, based on interviews with public and private employers. Our findings for 2009 show that families continue to face higher premiums, up about 5 percent from last year, and that cost sharing in the form of deductibles and copayments for office visits is greater as well. Average annual premiums in 2009 were

The individual insurance market before reform: low premiums and low benefits.

4,824 for single coverage and

Group Insurance: A Better Deal For Most People Than Individual Plans

13,375 for family coverage. Enrollment in high-deductible health plans held steady. We offer new insights about health risk assessments and how firms responded to the economic downturn.

How might immunization rates change if cost sharing is eliminated

Objectives. We sought to provide a benchmark for human immunodeficiency virus (HIV) testing availability and practices in U.S. hospitals prior to the Centers for Disease Control and Preventions (CDCs) 2006 revised recommendations. Methods. We conducted a survey of nonfederal general hospitals in the U.S. in 2004. Chi-square tests detected significant associations with hospital characteristics. Questionnaires were completed electronically via a secure Internet site or on paper. Nonresponse analysis was conducted and data were weighted to adjust for nonresponse. Results. HIV testing (on the basis of clinical symptoms or behavioral risk factors) was available in more than half of hospital inpatient units (62%), employee health departments (58%), and emergency departments (57%). Twenty-three percent offered routine screening (testing for people in a defined population regardless of clinical symptoms or behavioral risk), most commonly in labor and delivery. Teaching status, region, size, and type of metropolitan area were associated with the availability of HIV testing and routine screening (p<0.01). Hospitals used a variety of methods to link patients to care: referral to a hospital-based clinic (36%); on-site, same-day evaluation (35%); and referral to an unaffiliated HIV or community clinic (42%). Conclusions. Hospitals offered HIV testing on the basis of clinical suspicion or risk, but were far from meeting CDCs current recommendation to routinely test all patients aged 13 to 64. Hospital size, teaching status, and geographic location were associated with HIV testing availability and testing practices. Our understanding of current practice identifies opportunities for public health action at the practitioner, organization, and systems levels.

Health Benefits Offer Rates: Is There a Nonresponse Bias?

This article provides the first national estimates of actuarial values and out-of-pocket spending from the era of nonrestrictive managed care that began in the late 1990s. Employer plans paid about 84 percent of total medical expense for those with employer-sponsored coverage in 2004, about 1 percent less than in 2000, and high users faced potential out of pocket spending in the thousands of dollars when they received a portion of their care out of network. Since 2004, more employers have offered plans with higher deductibles coupled with employer-funded personal accounts. These arrangements can result in low out of pocket costs for many employees, but high users will face substantially higher costs. Many employers adopting high-deductible plans are not contributing to personal accounts. Those who are concerned about higher out-of-pockets might consider income-related cost sharing, educational efforts to communicate the savings that can result from using in-network providers, and continued availability of managed care options that limit out-of-pocket spending.

Health Benefits In 2005: Premium Increases Slow Down, Coverage Continues To Erode

Based on analyses of individual market health plans sold through ehealthinsurance and enrollment information collected from individual market carriers, this article profiles the individual health insurance market in 2007, before health reform. The article examines premiums, plan enrollment, cost sharing, and covered benefits and compares individual and group markets. Premiums for the young are lower than in the group market but higher for older people. Cost sharing is substantial in the individual insurance market. Seventy-eight percent of people were enrolled in plans with deductibles for single coverage, which averaged