Although there's been much angst about the dramatic priceincreases anticipated for Affordable Care Act health plans, a newreport from the National Business Group on Health shows that thecost of employer-based insurance, still by far the dominant sourceof health coverage, will rise only modestly next year.

The report estimates that the average cost of an employer-basedhealth plan will increase 6%. That outpaces inflation, but it is nogreater an increase than employers experienced over the past yearand it is lower than the anticipated 10% increase for plans offeredthrough the ACA exchanges.

“This is a clear indication that the employer-based health caremodel continues to be the most effective way to provide healthinsurance coverage to employees and their families,” said BrianMarcotte, CEO of the National Business Group on Health, a nonprofitthat represents large businesses.

That employers have been able to keep the growth of health carecosts relatively modest is particularly notable, the NBGH argues,in the context of “skyrocketing specialty pharmacy costs.”

In its survey of employers, the NBGH found that the rising priceof specialty drugs was by the top health care cost concern. Thecost of such drugs is expected to rise by more than 17% next year,meaning that for employers have had to reduce costs elsewhere intheir health care plans in order to keep the overall cost increaselow.

Many employers are looking to redesign their prescription drugbenefits to specifically reduce their spending on the mostexpensive specialty drugs. Three-quarters of employers signaledthat they were implementing or exploring more aggressiveuse-management protocols for specialty drugs, while nearly as manysignaled an interest in requiring that specialty drugs beprescribed through a specialty pharmacy benefit managementservice.

“Since many specialty pharmacy medications are infused orinjected, they are administered by physicians who, in turn, oftenbuy them and then bill for them,” Steve Wojcik, vice president ofpublic policy for the NBGH, explained in an email. “In this case,requiring that specialty pharmacy meds be obtained through thespecialty PBM means that they buy the meds, not the physician, andthey usually can get a better price than a physician practice.”

The second most commonly cited driver of health cost increaseswas high-cost claimants. The most effective way to reduce that costfor companies, of course, is to shift more of the cost of care ontothe employees, through high-deductible plans and consumer-drivenplans. More than half of employers surveyed said that offeringconsumer-driven health plans or mandating them for all employeeshad significantly reduced reined in health costs.

The survey also seemed to vindicate critics of wellnessprograms, since very few employers said they believed that wellnessinitiatives had a major impact on their budgets. Only a third ofemployers polled ranked wellness programs among the top threestrategies to control health costs.

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