While many employers plan to increase cost sharing in order to control rising costs, benefits managers are generally not optimistic about current cost containment strategies to curb rising premiums (Exhibit 12.5).
Few respondents view current cost containment strategies as highly effective for reducing premium increases. When asked which cost containment strategies they thought were very effective, 22% of firms cited disease management; 14% said consumer-driven health plans (e.g., high-deductible plans with a health savings account); 10% listed ‘higher employee cost sharing;’ and 6% said ‘tighter managed care networks.’ Each of these strategies, however, was viewed as somewhat effective by about half of the respondents.
Forty-two percent of all firms say they are interested in tighter managed care networks while 47% say they are not. Eleven percent of all firms say they don’t know. At the same time, only 10% of firms and one percent of large firms (200 or more work-ers) think their employees would find tighter managed care networks ‘very acceptable’ (Exhibit 12.6, 12.7).
Despite continuing efforts to educate firms about health plan quality, private sector efforts to accredit plans and measure quality remain largely unknown among smaller employers (Exhibit 12.8, 12.9).
Awareness of the accreditation activities of the National Committee for Quality Assurance (NCQA) or the Utilization Review and Accreditation Committee (URAC) – non-profit organizations that evaluate managed care plans – remains unchanged from 2001 and varies by firm size. While just 14% of all small firms (3-199 workers) are familiar with NCQA, awareness rises con-siderably to 71% among jumbo firms (5,000 or more employees).
Knowledge of the Health Plan Employer Data and Information Set (HEDIS) – a set of health plan perfor-mance measures established by NCQA – is also much lower among small firms: 6% of small firms (3-199 workers) are familiar with it, but 62% of jumbo firms (5,000 or more workers) are familiar with HEDIS.
The Leapfrog Group – a private- sector initiative developed to bring large firms’ health care purchasing strategies in line with the objectives of the Institute of Medicine’s study on medical errors, To Err is Human – is relatively well known among the largest firms (5,000 or more workers) at 49%, but virtually unknown among small firms with fewer than 1,000 employees (5%) (Exhibit 12.10).
