The great recession and passage of national health reform are together altering the calculus of employer approaches to offering health benefits, according to recent findings from the Center for Studying Health System Change's (HSC) visits to 12 nationally representative metropolitan communities.
HSC researchers found that employers responded to the economic downturn by continuing to shift health care costs to employees, with the trend being more pronounced in small, mid-sized, and low-wage firms. At the same time, employers and health plans alike are dissatisfied and frustrated with their inability to stem rising medical costs by either controlling utilization or negotiating more favorable provider contracts. Employers are increasingly turning to wellness programs as an alternative cost-control measure, although the long-term payoff remains unclear.
Uncertainty about how national reform will affect health benefits programs suggests employers are likely to continue their current course—at least in the near-term. Looking toward 2014, when many reform provisions take effect, employer responses likely will vary across communities, reflecting differences in state approaches to reform implementation, such as insurance exchange design, and local labor market conditions.