Cost sharing, tiered insurance, and high deductible health plans on the rise

In an effort to rein in health care costs, cost sharing, higher deductibles, and tiered health plans are all on the rise, according to an article in the Boston Globe.

According to the article, the percentage of workers who have individual deductibles greater than $1,000 has tripled since 2006, with an even sharper increase among small firms, where 50% of workers now have at least a $1,000 deductible.  Workers with deductibles of $2,000 or more has increased from 6% to 28% in the same time period. 

According to another Globe article, the number of patients with tiered insurance and limited network plans that require patients to pay higher rates for out-of-network care, are both on the rise. 

Critics of the tiered and limited network plans argue that patients who can not afford the higher cost plan, or the high out of pocket costs for some hospitals, are forced to go to lower-cost providers with less experience.  Critics also say that the metrics used to measure quality are not relevant to some conditions, such as cancer.

(Sources: The Boston Globe,, November 28, 2011; and November 30, 2011)