The rules for employers under the Affordable Care Act differ based on conditions including workforce structures and benefits offered, and many businesses, such as Tennessee-based Richards and Richards and the Brown Center for Autism, are still figuring out the rules, some of which have yet to be written.
Large employers are gearing up for a 7% rise in health care benefit costs next year, a survey from the National Business Group on Health revealed, which would make 2014 the second consecutive year with a significant rise. The survey also reported that large employers are relying more on consumer-directed health plans, which help them control health care costs.
Prices on brand-name drugs were up more than 13% in September over the previous year, and drugmakers are increasingly developing treatments for rare diseases and pricing those drugs at hundreds of thousands of dollars per patient per year. Drugmakers increasingly offer discount cards and copay coupons to help patients afford expensive brand-name drugs, but commercial insurers bear the brunt of the costs -- a cycle that keeps health care spending high. The nation will pay an extra $32 billion on prescription drugs over the next 10 years unless the use of discount cards and coupons is halted, a PCMA study found.
More pharmaceutical companies are issuing copay coupons as patents on brand-name drugs expire with few blockbuster candidates in the pipeline. The coupons may seem like a bargain to consumers, but they keep health care costs high because insurers' share of the cost is much higher than if the patient were taking a generic drug. A study last year by the Pharmaceutical Care Management Association found brand-name-drug copay coupons could increase prescription drug spending by $32 billion over the next 10 years.
At least 40% of seniors enrolled in Medicare prescription drug plans will choose a plan featuring a preferred pharmacy network, industry expert Adam Fein predicts. Sixteen Part D plans will offer a preferred pharmacy network in 2013, Fein writes. All feature copayment differentials for generic drugs, and all but two feature copay differentials for preferred brand-name drugs.