Reports and Surveys | October 12, 2020

2021 Segal Health Plan Cost Trend Survey

The current public health crisis has made understanding the factors influencing health plan costs and trends even more important for plan sponsors.

The data in this report helps you put in context the effectiveness and impact of your plan designs. It also proves invaluable as you calculate your upcoming plan budgets and negotiate rate renewals.

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Key findings from the health plan cost trend survey report

Projected medical plan cost increases for 2021 are similar to projections for 2020. This contrasts with last year’s survey, which reported a slowdown in medical trend projections. Other findings in this year’s survey include:

  • 2020 reductions in health plan costs as a result of pandemic-related suspension of non-essential care more than offset the cost to test and treat patients for COVID-19
  • Survey respondents project per-person cost trends for open-access PPO/POS plans to be 7.7 percent for 2021
  • The trend for outpatient prescription drugs is expected to be 7.3 percent for 2021
  • Double-digit specialty Rx cost rend, mostly driven by price increases and new specialty drugs, continues to be a challenge for plan sponsors
  • Provider price increases continue to be the primary driver for both medical and Rx trends
  • Trend projections for most dental coverages are lower for 2021
  • Vision trends are expected to decrease or stay the same
  • Medical trends for Medicare-eligible retirees are projected to increase
  • Health plan cost increases continue to significantly outpace general inflation and average wage increases

COVID-19 has caused unexpected disruption in our healthcare system and strained the healthcare ecosystem. Healthcare providers, carrier, and institutions will be looking for ways to offset anticipated financial losses. Plan sponsors hoping to avoid potential cost shifting must vigilantly monitor carrier policies and provider performance and pursue targeted cost-management strategies.

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Top health plan cost-management strategies in 2020

Plan sponsors continue to use various cost-management strategies to help mitigate increasing health plan costs. We asked survey participants to rank the top strategies being used by group health plans in 2020. The chart below compares the top five strategies being used today to last year’s ranking.


2020 top five

  1. Waiving cost sharing for treatment related to COVID-19
  2. Using healthcare transparency tools
  3. Implementing telehealth for behavioral health support services or enhanced virtual therapy sessions
  4. Including high-deductible health plan options
  5. Expanding pharmacy management programs

2019 top five

  1. Using healthcare transparency tools
  2. Expanding Rx management for non-specialty drugs
  3. Expanding Rx management for specialty drugs
  4. Implementing telehealth/virtual care
  5. Using value-based contracting

Get the data you need for next year's plan

Our Health Plan Cost Trend Survey remains one of the leading sources of original data that helps plan sponsors save costs without sacrificing care. Download the report now to stay ahead of the curve for next year's plan.

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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.

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