Darling said hospitals often point to labor and imaging as cost drivers while physicians say the insurance payment system itself drives up their costs of doing business. "They say they can't make a living talking to their patients or taking their histories because health insurers won't pay for that. They are paid by insurers to order and run tests."
Some employers said they increased their costs to prepare for increased utilization. Beth Ward, CFO of Wellmont Health System in Kingsport, Tenn. reported that her company, which self-insures, raised its expected costs by 5% "given expected increases in utilization -- particularly associated with drugs and chronic conditions -- even with our management of diabetes and coronary disease efforts."
She noted that because there are more non-paying patients, the reimbursement increases that hospitals receive from the insurers are going toward covering the costs of the uninsured. "It's a hidden tax on all of those that still have coverage."
The 13th annual Kaiser survey included 3,184 randomly selected public and private firms with three or more employees. The survey was conducted from January to May 2011.
This year some survey questions were specific to the Affordable Care Act. Writing for the White House blog, Nancy DeParle touted survey findings that she says demonstrate that health reform is already working.