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2015 HIX Premium Hikes May Top 7%

Christopher Cheney, for HealthLeaders Media, August 1, 2014

"When we look at rates, we also need to look at cost sharing," she said, adding that the number and scale of cost-sharing mechanisms on the exchanges such as co-pays and deductibles has fueled some of the harshest HIX criticism. "There's a lot of experimentation going on. At some point, we need to have fewer cost sharing options."

Healthcare providers view cost-sharing as a net negative financially because higher cost sharing results in a higher debt collection burden.

In July, the Robert Wood Johnson Foundation and Breakaway Policy Strategies released a report on exchange cost sharing in 2014. The key findings, which focus on HIX health insurance policies in the "silver" tier, include primary care physician visit copays as high as $75 and specialist visit copays as high as $150.

In addition, unlike most employer-sponsored insurance, many silver policies on the exchanges subject PCP and specialist office visits to a deductible, the report found.

"Anyone who's only looking at the premium rates in 2015 is going to miss a lot of action," Hempstead said.


Christopher Cheney is health plans editor at HealthLeaders Media.
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