Archived Insight | November 1, 2018

2019 Segal Health Plan Cost Trend Survey

Medical and prescription drug cost trends, for both actives and non-Medicare retirees, are projected to be lower in 2019 than in previous years.

That’s the headline finding from Segal’s 2019 Health Plan Cost Trend Survey, which surveyed more than 100 managed care organizations (MCOs), health insurers, pharmacy benefit managers (PBMs) and third-party administrators (TPAs).

Looking for the 2021 survey? Read it now. 

Get the Survey

medical cost trend 2019

Health costs keeping you up?

See how we can help. 

Speak with Us

Key Findings

  • Medical plan cost trends are projected to be lower than 2018 projections.
  • Actual medical and prescription drug trend results for 2017 were significantly lower than carrier projections for 2017.
  • Actual prescription drug plan cost trends for 2017 were the second lowest in the last 13 years.
  • Price inflation continues to be the primary driver of overall medical and prescription drug cost trends.
  • Network physician reimbursement rate increases are projected to increase by less than 2 percent for both primary care and specialists, below overall CPI rates.
  • Prescription drug cost-management strategies and improved vendor contracting are still plan sponsors’ top priorities.
  • We cover each key finding in the full report.
Download the Report

Prescription drug cost-management is still a top strategy.

Plan sponsors continue to use various cost-management strategies to grapple with ever-escalating health plan costs.

We asked the survey participants to rank the cost-management strategies implemented by group health plans in 2018. Here are the top five, compared with 2017.

Prescription Drug Cost Management Continues to Be Plan Sponsors’ Highest Priority Strategy

2018 Top Five

2017 Top Five
  1. Using specialty pharmacy management tools or techniques
  2. Intensifying pharmacy management program
  3. Adding low-cost primary care access
  4. Contracting with value-based providers
  5. Opioid abuse prevention management
  1.  Using specialty pharmacy management tools or techniques
  2. Intensifying pharmacy management program
  3. Contracting with value-based providers
  4. Increasing financial incentives in wellness design
  5. Adopting an HDHP

 

Find Out More: Download the Publication

In the full report, you’ll find examples of further strategies, based on our extensive surveying. We also cover where to focus cost-management efforts.

Download the Report

See more insights

Diverse business colleagues have a meeting

Reporting and Disclosure Guide for Benefit Plans 2025

Segal’s comprehensive Reporting and Disclosure Guide for Benefit Plans is the go-to guide for navigating compliance requirements.

Health, Compliance, Retirement, Multiemployer Plans, Public Sector, Healthcare Industry, Higher Education, Architecture Engineering & Construction, Corporate, Pharmaceutical

Read Full Insight

Mother and Child Exercising at Home

FSA v. HSA v. HRA Comparison Chart

Get our handy comparison chart, newly updated to include 2023 inflation-adjusted amounts for HSAs.

Health, Compliance

Get the Chart

Large Group Of Diverse People Wait To See Doctor

New Guidance on Preventive Services

The DOL, HHS and the Treasury have published new guidance on PrEP medication, breast reconstruction, and preventive services claims coding.

Health, Compliance, Multiemployer Plans, Public Sector, Healthcare Industry, Higher Education, Architecture Engineering & Construction, Pharmaceutical, Corporate

Read Full Insight

This page is for informational purposes only and does not constitute legal, tax or investment advice. You are encouraged to discuss the issues raised here with your legal, tax and other advisors before determining how the issues apply to your specific situations.