HealthLeaders-InterStudy, a leading provider of managed care market intelligence, reports that despite its trend-setter reputation, California is behind the curve in the consumer-driven health plan market, resulting in some sticker shock as insurers search for the right price for their products. According to the latest California Health Plan Analysis, fewer than 4 percent of California employees are covered by tax-advantaged, high-deductible products, also known as consumer-driven health plan products, which are increasing in popularity nationwide. According to one 2008 study, consumer-driven products represent about 5.2 percent of employer-sponsored health plans in California, compared to nearly 13 percent nationally.
"The strength of HMOs in California is one reason that uptake of consumer-driven plans has been slow," said Chris Lewis, analyst with HealthLeaders-InterStudy. "Residents are familiar with HMOs and the predictable fees and copays associated with them. However, as prices of HMOs are increasing and catching up to PPO premiums, employers are looking for more choices and are becoming more educated about the health plan options out there."
Insurers are meeting market demand by providing high-deductible plans to employers, but pricing of these consumer-driven plans has been a challenge. For example, Anthem Blue Cross hiked fees for one of its Lumenos plans by more than 32 percent in May 2008. According to Anthem Blue Cross officials, the price increase was necessary to respond to an expensive, and unanticipated, number of claims.
"Carriers had thought that with a high-deductible plan, consumer medical spending would be more moderate than it turned out to be," noted Lewis. "As a result, some employers responded to high renewal rates by changing carriers, while others reverted back to the more traditional plan options. In response, insurers in California are striving to reach the delicate balance on price where they are attracting customers to their consumer-driven products, without having to ask for a huge increase a year later to cover an unanticipated spike in claims."
Why Pharmaceutical Companies Need Health Plan Analysis
Health Plan Analysis identifies key health plan trends, which can be used by pharmaceutical companies to create comprehensive strategic plans and sales strategies at state and local levels. Updated quarterly, Health Plan Analysis provides a detailed look at plan design and financials, as well as information about mergers, legislation and other influencers driving healthcare in a particular region.
HealthLeaders-InterStudy, a Decision Resources, Inc. company, is the authoritative source for managed care data, analysis and news. For more information, please visit www.HL-ISY.com.
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CONTACT: Lisa Osgood, of HealthLeaders-InterStudy, +1-781-296-2606,
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