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U.S. Health Care Costs

Medical Trend Projections

Health care costs continue to increase at a rate greater than inflation, and health care costs are expected to continue to outpace inflation over the coming year.

For more information on this chart, please see the National Business Group on Health’s Special Report: The Cost of Employer-Sponsored Health Care.

Specialty Pharmacy Costs Continue to Increase at Unsustainable Pace

While the costs of traditional pharmaceuticals are increasing at a very low rate over the last few years, the spiraling costs of specialty pharmaceuticals promises to offset any potential savings.

For more information on this chart, please see the Express Scripts’ Drug Trend Report.

Total Health Care Costs for Large Employers and Their Employees

In addition to rising employer and employee contributions to health care premiums, employees are experiencing rising out-of-pocket costs.

For more information on this chart, please see Aon Hewitt’s Health Value Initiative.

 

Cost Per Employee, by Plan Type

The average cost per employee in an HSA-eligible continues to be significantly lower than the average cost per employee in a PPO or an HMO.

For more information on this chart, please see Mercer's National Survey of Employer-Sponsored Health Plans report.

Prescription Drug Benefit Cost Trend

After a ten year decline in prescription drug trend, pharmacy costs are now on a three year rise. Prescription drug trend now outpaces medical trend overall.

For more information on this chart, please see Mercer's National Survey of Employer-Sponsored Health Plans report.

Components of Health Care Spending

The total medical spending for a typical family of four under a PPO in 2016 is estimated to be $ 25,826, according to Milliman.

For more information on this chart, please see the Milliman Medical Index report.

Public Exchange Silver Plans vs. Large Employer CDHPs

Beyond subsidized premiums, employer plans tend to have lower out-of-pocket costs for employees and their families – including deductibles and out-of-pocket maximums.

 

For more information on this chart, please see our Large Employers’ 2017 Health Plan Design Survey.

Health and Productivity Costs as a Percentage of Payroll

The direct and indirect costs of health and productivity have continued to rise, accounting for a greater proportion of payroll costs. Much of that increase is due to increasing medical costs, but the increase in overtime and replacement workers has also had an impact.

For more information on this chart, please see the National Business Group on Health/Towers Watson’s 2011/2012 Staying@Work report.

Large Employers’ Trend Generally Exceeds National Health Expenditures Trend

Current projections indicate that National Health Expenditures (NHE) will increase at more than 5% per year for the next decade, which is a concern because on average large employers’ medical trend has outpaced annual NHE increases for more than a decade.

For more information on this chart, please see our What Your CEO is Reading: National Health Expenditures.

Can't find what you need, please contact us at benchmarking@businessgrouphealth.org.