Health Plan Cost Trend Survey by Segal Reveals Impact of COVID-19 Public Health Crisis

·3-min read

The Annual Report Helps Health Plan Sponsors Explore Innovative Cost-Management Strategies

Segal, a leading employee benefits consulting firm, has released its 2021 Health Plan Cost Trend Survey. Year to date health plan costs have decreased in 2020 as non-essential care was suspended for portions of the year due to COVID-19. The postponement of non-essential care more than offset the direct new costs to test and treat patients for the virus. Health plan costs are expected to return to pre-COVID levels in 2021. Forecasts for prescription drug plan costs in 2021 are expected to exceed 7% per annum, primarily driven by price increases for specialty drugs, which are projected to increase by 11.5 percent on an annual basis. The cumulative cost increase for prescription drugs from the past decade and into 2021 is demonstrated in the accompanying graphic.

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Prescription drugs are expected to continue to rise in cost, the 2021 Segal Health Plan Cost Trend Survey finds. (Graphic: Business Wire)

The Segal survey is known as one of the most definitive surveys on employer-sponsored health plans. The 2021 survey is Segal’s 24th annual survey of health insurers, managed care organizations (MCOs), pharmacy benefit managers (PBMs) and third-party administrators (TPAs). Survey respondents represent more than 80 percent of the commercially insured and self-insured market. Those surveyed shared their 2021 trend forecasts for medical, prescription drug, dental and vision coverage and actual 2019 health cost trends based on their group health plan experience. In addition, Segal’s annual survey report provides insight on how plan sponsors can address growing health costs.

"We expect next year to be a return to normal when it comes to healthcare costs. Yet we recognize the pandemic’s impact on future cost increases is still uncertain. As a result, plan sponsors need to closely track their plan costs and vendor premium and fee renewals in the months ahead," said Edward Kaplan, Senior Vice President and the National Health Practice Leader at Segal. "We’ve developed a variety of cost-management strategies to help organizations mitigate increases in health plan costs while maintaining access to high-quality healthcare. For the coming year plan sponsors may wish to explore total well-being programs, expanding access to specialized virtual therapy options, evaluating value-based arrangements and more efficient provider networks."

Kaplan recommends plan sponsors study the key cost drivers for the plans to determine which targeted cost containment strategies will have the biggest impact to reduce excessive claim expenses. By evaluating actual group claims history and utilizing strategies that address the problem areas, plans can dramatically reduce cost trends without reducing the value of plan coverage offered to plan participants.

About Segal

Segal provides trusted advice that improves lives. Segal is a privately-owned benefits, human capital, communications, technology, insurance brokerage and investment consulting firm with more than 1,000 employees throughout the U.S. and Canada. Segal, Segal Marco Advisors and Segal Benz are all members of the Segal family.

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Amira Rubin