The consulting firm concluded that employers will stick with cost-shifting and with encouraging employees to get coverage via high-deductible plans, and more will restrict coverage to employees rather than offering it to spouses and other dependents. Aon's research showed:

18 percent of companies have reduced subsidies for covered dependents, while 17 percent added a surcharge for adult dependents with access to other health coverage.
43 percent of companies are considering using unitized pricing — where employees pay per person and not individual versus family.

Aon said big companies are also using their clout to pursue the longer term strategy of paying for quality by gradually incentivizing employees to get their medical care through certain approved physicians and hospital systems. Among the trends cited:

Steering participants (through plan design or lower cost) to high quality hospitals or physicians for specific procedures or conditions (22 percent);
Offering value-based insurance design approaches (28 percent);
Adopting reference-based pricing — where employers set a pricing cap on benefits for certain medical services for which wide cost variation exists with no discernible differentiation in quality (6 percent). Another 53 percent plan to do so in the next three-to-five years.

And to combat the current "bad guy" in the health cost equation — prescription drugs — "employers are adjusting pharmacy design components to encourage the use of generic drugs. This includes using coinsurance rather than copays for brand drugs and by introducing mandatory generic and step therapy programs."

Instant Insights /

Health costs hike drops, but employee costs soar

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