Survey: CA Employers May Shift Health Costs but Don't Like It

February 3, 2005 ( - California employers may be stepping up their cost-shifting to workers to help the companies rein in health coverage costs, but that doesn't mean the employers are very happy about it.

Recent surveys commissioned by the California HealthCare Foundation (CHCF) show that even as employers shift health costs, they worry about what it is doing to their workers’ health.

Although he cost-shifting strategy has led a majority of employers to feel that their health care costs are more under control today than they have been in years past, three quarters say the move prompts consumers to forgo needed medical care and particularly hurts those with chronic conditions. Over 40% of employers also believe that cost sharing reduces the productivity of workers.

Consumers confirmed employer concerns. The survey of the general population of adults in California found that one in seven adults had a medical condition but did not obtain care due to cost in the past year. Non-compliance with recommended medical treatment is particularly common among those with low incomes and those in fair or poor health, according to the survey.

Survey results from California employers reveal that many believe cost-sharing can encourage consumers to spend more wisely on health care and reduce unnecessary doctors’ visits, but they are slightly less likely to cite these positive advantages than they were in a 2002 Harris Interactive survey of California employers. Not surprisingly, the adult consumer surveys of Californians also found that many are less satisfied with their health benefits than they were a couple of years ago. However, a large majority of those with insurance are at least somewhat satisfied.

The concerns about the impact of cost-sharing on those adults with chronic illnesses also appear to be on target, at least based on a related survey of chronically ill adults in California. The survey found that individuals in especially poor health and those with lower incomes are more likely to have problems paying their medical bills than others.

According to the surveys, chronically ill adults in especially poor health or with low incomes are more likely to go without needed care due to cost (e.g., by skipping an annual check-up, not visiting a doctor for a problem, or not using a recommended medical device) than the general adult public in California.

The surveys also found:

  • Employers are more likely to reduce retiree health benefits in the near future today than they were in 2002
  • Other employer strategies for controlling costs, used less frequently than in 2002, include increasing premium contributions, changing health insurance carriers, and reducing the scope of benefits
  • One-third of employers believe that disease management and wellness programs are effective when it comes to improving quality of care.
  • Adults in California are less worried about benefit cutbacks and more concerned about being able to pay for services
  • Adults in California with tiered prescription drug benefits are more likely than those with other types of drug coverage to request generics, use less expensive prescriptions, use mail order, or go without filling prescriptions altogether

The survey findings are summarized in two reports, Health Care in CaliforniaCalifornia’s Chronically Ill: Coping with Rising Health Care Costs.Harris Interactive conducted three surveys. The first survey was conducted by telephone between June 17 and July 14, 2004, among 301 California employers with five or more employees. The second survey was conducted by telephone between June 20 and August 1, 2004, among 1,000 California residents aged 18 and over. The third survey was conducted online between July 6 and 27, 2004, among 3,255 California residents aged 18 and over who have a chronic health condition.