Self-Insurance Will Pick up Steam in California as Mid-Size Employer Groups Struggle to Control Healthcare Expenditures

California Health Plan Analysis Now Available from HealthLeaders-InterStudy

NASHVILLE, Tenn.--(BUSINESS WIRE)-- HealthLeaders-InterStudy, a leading provider of managed care market intelligence, reports that sales of self-insured products are expected to accelerate in California as mid-sized employer groups look for alternatives to control healthcare expenditures. According to the recent California Health Plan Analysis, as premiums continue to rise in the fully-insured commercial market and the effects of healthcare reform phase in, more employer groups in California will consider taking on the risk of paying their own medical claims.

A trendsetter in this area is CIGNA HealthCare, which has been experiencing a significant sales increase in a self-funded product tailored to smaller groups. Other carriers in the state are expected to respond to this shift by developing self-funding products that will offer financing plans that could potentially mitigate the risk associated with paying all of a group’s medical claims. As employers become more aware of the expenses related to paying for these medical claims, they will likely be adopting strategies that promote wellness and management of chronic conditions.

“More companies, especially those with healthy workers, are considering self-insurance to avoid premium increases that are beyond their control in the increasingly regulated fully insured market,” said Chris Lewis, senior market analyst with HealthLeaders-InterStudy. “Although there are risks, self-insured employers get the benefit of a full accounting of their medical and pharmacy claims to help them gain more control over their groups’ expenses. Pharmaceutical companies will want to watch this trend, as more employers will be looking for opportunities to help keep their members well and lower their healthcare costs—including programs that increase compliance with drug treatments.”

Other topics highlighted in the recent California Health Plan Analysis include:

  • The pressures that Medicaid plans will encounter as the state faces another year of financial challenges
  • Patient care management strategies, including the formation of accountable care organizations and medical homes
  • How plans across the state feel about the proliferation of coupons being offered by pharmaceutical companies to provide copay relief on branded drugs

Why Pharmaceutical Company Managed Markets Teams Need Health Plan Analysis

Health Plan Analysis identifies key health plan trends, allowing pharmaceutical companies to create comprehensive strategic plans and sales strategies at state and local levels. Updated quarterly, Health Plan Analysis provides a detailed look at plan design and financials, as well as information about mergers, legislation and other influencers driving healthcare in a particular region.

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Erin O’Leary, 781-993-2641
[email protected]
Decision Resources, Inc.
Elizabeth Marshall, 781-993-2563
[email protected]

KEYWORDS:   United States  North America  California  Tennessee

INDUSTRY KEYWORDS:   Practice Management  Health  Professional Services  Insurance  General Health  Managed Care