Policy makers are interested in how many employer health plans are self-insured and in identifying forces that lead to change. This article reports on findings from the 1993 and 1997 Robert Wood Johnson Foundation Employer Health Insurance Surveys. The percent of businesses self-insuring fell over this period at all size levels, but the change was largest for small employers. The decline seems to be related to growing opportunities to take advantage of the lower costs offered by HMOs. Recent changes in state insurance regulation do not appear to have affected the choice to self-insure.
Originally published in: Health Affairs, v. 18, no. 3, June 1999, pp. 161-166.
This report is part of the RAND Corporation reprint series. The Reprint was a product of the RAND Corporation from 1992 to 2011 that represented previously published journal articles, book chapters, and reports with the permission of the publisher. RAND reprints were formally reviewed in accordance with the publisher's editorial policy and compliant with RAND's rigorous quality assurance standards for quality and objectivity. For select current RAND journal articles, see External Publications.
The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.