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Texas Health Plans Implementing Cost-Sharing From Employers to Employees by Focusing on Increasing Generic Utilization
Date:9/21/2010

NASHVILLE, Tenn., Sept. 21 /PRNewswire/ -- HealthLeaders-InterStudy, a leading provider of managed care market intelligence, reports that the Texas Employee Group Benefits Program, the state's largest employee group, is implementing further cost-sharing for its members, and will continue to steer members towards generic drugs. According to the Texas Health Plan Analysis, more private groups in Texas are going to be shifting costs to their employees.

According to the report, as more private groups try to save money and as members become more aware of safe pharmaceutical alternatives, generic utilization will continue to increase. Plan members will face higher co-pays if choosing a brand name pharmaceutical when generics are available. In addition, the report also finds that as private groups follow the lead of the Texas Employee Group Benefits Program, members will face increased deductibles, out-of-pocket maximums and coinsurance costs for all members.

"Texas' largest employee group has implemented changes that could make waves among many private groups," states Bill Melville, market analyst with HealthLeaders-InterStudy. "With higher co-pays, the Texas Employee Group Benefits Program could be a signal of what's likely to occur in private employer groups. Additional cost-shifting strategies include increased deductibles, out-of-pocket maximums and coinsurance costs."

Other topics highlighted in the recent Texas Health Plan Analysis include:

  • Changes in the rules governing rebates from pharmaceutical companies, which could lead to a carve-in of pharmacy benefits for the state's Medicaid program.
  • The quick movement of providers moving to establish accountable care organizations

    • Why Pharmaceutical Company Managed Markets Teams Need Health Plan AnalysisHealth Plan Analysis identifies key health plan trends, allowing pharmaceutical companies to create comprehensive strategic plans and sales strategies at stat
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    SOURCE HealthLeaders-InterStudy
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