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Doctor with piggy bank According to EBRI, coinsurance reduces use of inpatient care and specialist physician office visits more than copayments do. (Photo: Shutterstock)

Not all of an employer’s health insurance plan participants are the same. As a general rule, 20% of the population accounts for about 80% of health-care spending.

Recent research found that many high-cost claimants reach not only their deductible but also their maximum out-of-pocket limit. In essence, for these individuals, use of health-care services early in the year affects what they pay at the end of the year. Because deductibles often are satisfied early in the year by high users of health-care services, it can be argued that it is the end-of-year price that matters most in decision making.

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