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Employees with Health Insurance Worry over Rising Costs, Survey Finds

By Jane Norman, CQ HealthBeat Associate Editor

May 24, 2010 -- When it comes to health care coverage, it's all about the money — even among Americans with relatively stable health insurance coverage.

That's a key result from a survey of employees and their spouses by the consulting firm Hewitt Associates, conducted for the National Business Group on Health and released Monday. Among the more than 3,000 workers, most of them employed by large businesses with group plans, an overwhelming majority — 94 percent — said controlling health care costs is what's important to them as the health care overhaul plays out.

In last place among their priorities was a requirement that every American have health insurance, seen as important by just 48 percent of those surveyed. Workers were asked to rate a variety of factors as very important, important, not very important and not important at all.

Cathy Tripp of Hewitt said the survey was taken in February and March, prior to the enactment of the new health care law. "It was almost twice as important to consumers that took this survey that costs were controlled" than ensuring that everyone has insurance, she said. About 70 percent of those who took the survey were very concerned about costs, particularly those who were older, female or had chronic illnesses, she said.

Helen Darling of the business group, which is non-partisan and represents large employers, said that employers have been discouraged in many cases to find employees aren't as engaged in their own health care behavior or decisions as they should be. Yet businesses are under pressure to keep costs down and help employees stay healthy, she said.

The survey was done to help employers get an idea of what drives behavior change, how employees have been affected by the economic downturn, what encourages workers in terms of getting healthy and which employer-sponsored programs attract employees. The survey included 3,026 men and women between the ages of 23 and 69 either working at large employers or with spouses who worked for large employers, all with employer-sponsored coverage.

Tripp said employees know how to get healthy but aren't taking action to improve their health. She pointed to survey results that found people are best at getting screenings or knowing "numbers" — for example, their blood pressure readings or weight. They don't do as well when it comes to exercise, seeking health advice and maintaining a healthy diet. "The thing people struggle with the most is exercise," Tripp said.

The No. 1 obstacle to being healthy is not knowing what information to trust, cited by 58 percent of those surveyed. Other common problems are confusing information about health and workers' lack of knowledge about what's covered by their plans or what services might cost.

Hewitt officials said the survey found that participation in employer-sponsored programs is low but satisfaction is high once employees do sign up. Workers said the tools that would help them the most would be personalized reminders about screenings, personalized healthy lifestyle plans and an online personal health record. Those they saw as least helpful were health coaches and a physical tool kit to manage paperwork.

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