Payments for Cost Sharing Increasing Rapidly Over Time

This updated Kaiser Family Foundation analysis tracks a trend of rising out-of-pocket costs outpacing costs paid by insurers for workers covered by their employer’s health plans.

Between 2005 and 2015 covered workers’ average out-of-pocket costs grew 66 percent, outpacing health plans’ average payment per enrollee, which rose by 56 percent. Wages, meanwhile, rose by 31% during that period. Overall, workers’ out-of-pocket costs rose from an average of $469 in 2005 to $778 in 2015, while average payment by health plans rose from $2,932 to $4,563.

The brief examines a sample of claims from large employer plans contained in the Truven Health Analytics MarketScan Commercial Claims and Encounters Database.

The analysis is part of the Peterson-Kaiser Health System Tracker, an online information hub dedicated to monitoring and assessing the performance of the U.S. health system.

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