I wouldn't get too excited by the findings in a recent study that included the surprising results that patients' share of health care costs had fallen over a roughly three-decade period.

The study, published in the Journal of the American Medical Association earlier this month, found that patients' contribution to the nation's health care expenses stood at 22.8 percent in 1980, far higher than the 13.1 percent in 2011.

At the time, I took a look at the numbers the study was based on to see if the authors were mining the data for specific results or perhaps missed something, and I couldn't find much. Frankly, I was disappointed, because the results didn't seem right.

But, as the saying goes, that was then and this is now. And now is when patients are paying a bigger share of their health care costs, at the very least in Medicare Advantage plans.

The JAMA study covered 31 years running through 2011. But a new Kaiser Family Foundation study of privately run Medicare Advantage plans paints a different picture for limits on out-of-pocket spending in 2014.

The percentage of Medicare Advantage plans carrying an annual out-of-pocket spending limit in the $5,000 to $6,700 range rose to 41 percent in the coming year from 25 percent in 2013.

The Centers for Medicare & Medicaid Services set a cap of $6,700 on MA plans and encourages plans to limit out-of-pocket to $3,400, according to the Kaiser foundation study. The percentage of plans limiting out-of-pocket to $3,400 fell to 37 percent from 48 percent in 2013, according to the Kaiser study. And the average plan out-of-pocket limit rose to $4,797 from $4,333.

The changes follow previous years' trends of more plans offering higher out-of-pocket limits, but they also represent a sharper shift than occurred in 2012 and 2013. That's likely to catch a lot of Medicare Advantage plan members off guard, particularly if they're accustomed to a certain level of out-of-pocket limits and just rolling over in the same plan.

Of course, a Medicare Advantage plan is not representative of all insurance coverage in the United States, but it offers a unique window into what private insurers are asking for patients to cover in a format that is available publicly from the government.

And my guess is that group employer plans are following the same tack. I have heard anecdotally of employers switching to high-deductible health plans for 2014, and nothing about employers going the other way, dropping an HDHP.

Are you in a position to see how much of their care is being covered by patients? Is what you're seeing closer to what's happening in the Kaiser study or the AMA study?

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