Health care costs will take another leap next year, and more employers will ask their workers to help absorb that by paying deductibles even if the care is within a plan's network of providers, according to the consulting firm PwC.
The percentage of companies that ask their employees to pay deductibles for in-network care has grown steadily the past few years. For instance, PwC said only 11 percent of the companies it surveys annually on expected health care costs reported deductibles of $1,000 or greater in 2009. But it expects that total to rise to 28 percent next year.
The percentage of employers with deductibles of $400 or greater will climb to a projected 54 percent next year from 31 percent in 2009.
Deductibles are the annual amount a patient pays out of pocket for care before insurance coverage starts. They are generally separate from co-payments and coinsurance.
"A few years back, you didn't even have deductibles in network," said Mike Thompson, a principal with PwC. "I think employees can expect to share in more and more of the cost going forward."
Companies raise in-network deductibles because it's an easier way to address rising health care costs than more drastic measures like changing provider networks or prescription drug coverage, said Paul Fronstin, director of health research and education for the Employee Benefit Research Institute. He didn't participate in the PwC study.
"It's a simple financial shift that doesn't affect anything else," said Fronstin, noting that healthy people who use little health care may not notice much of a change.
PwC surveys companies every year to get a sense for the projected increase in the cost of medical services. For its 2012 report, it surveyed about 1,700 U.S. employers and interviewed hospital executives and health insurance actuaries.
The firm found that medical costs are expected to rise to 8.5 percent next year, which compares to an 8 percent increase it projected for 2011.
But this doesn't mean workers will see their monthly premiums jump by the same amount. Companies can do things like raise deductibles or change benefit-plan designs to keep actual premium increases below the cost rise.
PwC said last year that costs would rise 9 percent in 2011 but then lowered that figure to 8 percent because of slower-than-expected growth in care use.
Analysts and insurance executives say cost increases have been rising more slowly than expected in part because people tend to hold off on care in the aftermath of a deep recession. But Thompson said that trend is starting to ease.
"There is evidence that there's this pent-up demand for services that is starting to get realized," he said.
The health care overhaul that was passed last year and aims to control costs and eventually cover millions of people will have little impact on next year's costs because the few provisions that have unfolded so far involved small changes that employers already accounted for, PwC said.