Managing Health-Care Costs

How Employers Are Responding to Rising Costs

As health-care costs continue to rise, employers are finding ways to manage them while still offering employees health insurance benefits. Some of these changes include:

• Increasing employee contributions to health-care premiums
• Raising copayments and deductibles
• Switching to health-care plans with lower rates
• Offering a high-deductible health-plan option with a health savings account (HSA)
• Purchasing health care jointly with other businesses
• Reducing the amount of coverage offered

In some cases, employers may choose not to offer coverage if insurance costs get too high.

How Insurance Companies Help Control Costs

One way insurance companies help control costs is by working with hospitals and other providers to create plan networks. By negotiating lower-cost contracts with these provider networks, they can pass on cost savings to you. That's why if you're enrolled in a plan with a network, you'll save money by visiting in-network providers.

Some other ways health plans contain costs include:

• Same-day surgery admission. Health plans may require that surgery patients go to the hospital the day of the procedure instead of the night before, cutting one whole day of hospitalization fees.
• Pre-admission testing and second opinions. Your health plan may ask you to go through additional tests or get a second opinion before undergoing a costly surgical procedure or treatment.
• Outpatient surgery. If a procedure or surgery does not require overnight recovery, your insurance company may require you to have it on an outpatient (non-hospitalized) basis.
• Prior consent and limitations. Insurance companies may require that you get their permission before they will cover certain treatment or procedures. In addition, some plans may deny hospitalization or charges for a medical procedure if they find it exceeds normal costs or is an unnecessary treatment.
• Specialized Care Programs. These services are designed to help you and your family handle specific conditions like cancer, obesity, heart health and pregnancy. Specialized care programs can provide you with information on treatment options.
• Health and Wellness Education & Services. Check your plan's member website for resources, tools and interactive activities designed to help you stay healthy. In addition, your plan may offer discounts on wellness products and services like fitness club memberships and laser vision correction. Stretch your health-care dollars by taking advantage of these resources and programs.