Insights

Leavitt Partners Releases “Nationally, Individual and Group Market Costs Increasingly Similar” White Paper

Salt Lake City, October 23, 2017 –Today, Leavitt Partners released, “Nationally, Individual and Group Market Costs Increasingly Similar,” a white paper that examines total incurred costs and premiums per member per month for the individual, small, and large group markets from 2010 to 2016.

The authors compare average claims expense across the individual and group markets by analyzing total incurred medical claims from 2010 to 2016, both before and after the Affordable Care Act (ACA) insurance market regulatory changes went into effect in 2014. Two key findings include:

  1. On the national level, total incurred costs per member per month for the individual and group markets are converging and achieving parity;
  2. On the national level, premiums per member per month for the individual are still lower than premiums for the small and large group markets.

The ACA’s 2014 market reforms appear to have brought the individual market costs into greater alignment with the group market, although individual market premiums remain lower. If costs in the individual market rise beyond the point of parity with the group market, then the increases may be

more indicative of the structure and makeup of the market than with just underlying health care costs.

The white paper can be accessed here.

About Leavitt Partners:

Leavitt Partners is a health care intelligence business. The firm helps clients successfully navigate the evolving role of value in health care by informing, advising, and convening industry leaders on value market analytics, alternative payment models, federal strategies, insurance market insights, and alliances. Through its family of businesses, the firm provides investment support, data and analytics, member-based alliances, and direct services to clients to support decision-making strategies in the value economy. For more information please visit www.LeavittPartners.com.