Cost Sharing and the Changing Pattern of Employer-Sponsored Health Benefits
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abstract
One of the most striking features of American health care in the 1980s has been an apparent near- revolution in employer initiatives to control the costs of health- related fringe benefits. Reportedly, employers are redesigning group insurance plans to increase consumer cost sharing, offering employees the option of joining a health maintenance organization (HMO), increasing employee premium contributions, and implementing uti- lization review programs aimed at assessing the appropriateness of services. Because employers provide the major share of health insurance in the United States, these changes have important implications for the conduct and performance of medical care markets.