By Phillip L. Polakoff, M.D.

Take a close look at this year's calendar. That pair of 2s, one each at either end of 2002, could well stand for the double-digit increase in health care costs some experts see coming your way.

Hewitt Associates, a global management consulting and outsourcing firm, says average increases of 13 to 16 percent, depending on the type of health plan, are likely in 2002.

If you're covered at work, what do these projected cost increases mean for you?
While some companies will absorb the majority of next year's rate hikes, according to Hewitt, many will pass along at least 25 to 30 percent of the increase to employees.

With the average health plan projected to cost $5,524 per employee nest year - up from $4,778 in 2001 - that pass-along share of the increase means that employees will pay between $186 and $223 more for their health coverage in 2002.

These numbers are based on Hewitt's database of more than 2,000 health plans in 139 U.S. markets, including 300 major employers and more than 16 million health plan participants.

Rate hikes of at least 13 to 16 percent will affect every major U.S. metropolitan area next year, according to the survey. That comes on top of significant increases in 2001.

From the employer standpoint, the consulting firm says "the primary and most reliable means to control short-term cost increases is re-evaluating employee contributions and out-of-pocket cost-sharing strategies."

Jack Bruner, Hewitt Associates' national health care practice leader, adds: "Employers are focusing on ways to structure cost increases in an effort to prompt employees to migrate to more cost-efficient plans, to use spousal coverage, reduce discretionary use, or to select lower-cost therapies."

From the workers' standpoint, and the standpoint of their unions, talk of "migrating" to lower-cost plans, reducing discretionary use, and selecting lower-cost therapies will set off warning bells, calling for close attention and analysis.

Cutting costs must not translate into cutting corners in health care for workers. 
Researchers continue to find significant variations in cost, quality, administrative efficiency and rates of increases in local health plans.

Whenever higher-scoring plans can replace those ranking lower - without impairing the basic purpose of taking care of workers - there can be no quarrel with employers making the most prudent choice.

Companies with employee populations that have a high prevalence of specific health conditions such as asthma, diabetes or heart problems are beginning to contract with health plans that offer programs specializing in those areas. Many of these plans place strong emphasis on workers managing their own condition. This trend bears watching.

(Dr. Polakoff is the medical writer for Press Associates)