Cost sharing and the changing pattern of employer-sponsored health benefits.

The perception that employers have been redesigning group health benefits to encourage more cost-effective use is distorted by limited study methods. New estimates of initiatives undertaken by larger private-sector employers--based on nationally representative data from the U.S. Bureau of Labor Statistics--reveal a more uncertain picture of cost containment. Cost sharing for initial hospital stays was broadened between 1981 and 1985, but coverage in most other areas--categories of care, lifetime benefit limits, etc.--was actually increased. Real health care expenditures will continue to grow absent more significant employee cost sharing.