PODCAST: A Three Decade Long History of Employer-Sponsored Healthcare Costs

The History of Employer-Sponsored Healthcare Costs in the Last 30 Years Can Be Broken Down Into 3 Segments:

THREE VITAL SEGMENTS

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BY ERIC BRICKER MD

1) The 90s HMOs: Lower Premiums, Lower Out-of-Pocket Costs, Many Many Rules Restricting Care.

2) The 2000s PPOs: High and Even Higher Premiums, Lower Out-of-Pocket Costs, Fewer Rules Restricting Care.

3) The 2010s CDHPs: Lower Premiums, HIGH Out-of-Pocket Costs, Fewer Rules Restricting Care.

The Last 30 Years Have Taught Us that Employer-Sponsored Health Plans CANNOT Have All 3–Low Premiums, Low Out-of-Pocket Costs and Few Care Restrictions.

In the 2020s, Employers Are Moving More of Their Employee Healthcare OUTSIDE of the Traditional Healthcare and Health Insurance System with On-Site Clinics, Near-Site Clinics, Virtual Urgent Care, Virtual Primary Care and Bundled-Payment Centers-of-Excellence.

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Citation: https://www.r2library.com/Resource/Title/0826102549

MANAGED CARE HISTORY: https://medicalexecutivepost.com/2014/11/19/a-brief-history-of-managed-care/

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THANK YOU

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Patient Satisfaction with Health Coverage?

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Traditional Plans, HDHPs and CDHPs for 2005-2013

By http://www.MCOL.com

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On Medical Pricing Transparency

For Hospitals, Clinics and Physicians

[By Staff Reporters]

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In 2007, federal and state legislatures called for hospitals across the country to make their prices “transparent.” The term was defined as the full, accurate, and timely disclosure of hospital charges to consumers of healthcare, as well as the process employed to arrive at those fees. Moreover, transparency does not merely involve publishing a list of prices and fees.  Essentially, hospital CXOs must be able to present their prices in a manner that is understandable to the general public and they must be prepared to explain the rationale behind their charges.

State Initiatives

More recently, at least 38 states have already proposed or passed legislation regarding publication of hospital charges. For example, the average cost for a hip, knee or ankle joint replacement is $38,443; while a heart valve operation is $124,561and a back fusion is $60,406.  Torrance California based HealthCare Partners now notes on its Website that it charges $15 for flu vaccines, $61 for a chest X-ray, while a colonoscopy costs $424.

Assessment

Such initiatives demonstrate increased industry competition and advancing patient empowerment with CDHPs.

Current Updates for 2010

Link: http://www.govtrack.us/congress/bill.xpd?bill=h111-2566

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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Consumer Directed Health Plan Survey

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Costs Hold Steady

[By Staff Reporters]

ho-journalAccording to Tracey Walker, Senior Editor of Healthcare Executive News on March 13, 2009, US employers expect healthcare cost increases to hold steady at 6%. Additionally, more plan to adopt consumer-directed health plans [CDHPs] in 2010, in an effort to control health cost increases.

Watson Wyatt – National Business Group Survey on Health

And, a survey by Watson Wyatt and the National Business Group on Health, found that:

  • Approximately half of companies now offer workers a CDHP, up from 47% in 2008, and another 8% are expected to adopt a CDHP by 2010.
  • CDHPs are helping employers control costs—companies with at least half of their workers enrolled in a CDHP have a two-year cost trend (4.6%) that is 25% lower than non-CDHP sponsors (6.1%).
  • Two-thirds of employers (67%) cite the poor health habits of their employees as a considerable challenge to managing their health costs.
  • While companies will be taking a close look at benefit offerings because of the recession, most do not plan major changes.
  • Nearly 30% of employers have revamped their healthcare strategy with another 30% planning to do so in 2009.

Assessment

The growth in CD-HPs has made it more important than ever for health plans to provide their members actionable information and pricing transparency to navigate the healthcare system. According to Dr. David Edward Marcinko;

“Members like our firm – and many others – are incented to be savvy consumers, but that’s a difficult task if not provided with the pricing and related information we need to make wise choices. And, to make matters even worse for lay patients; providers and hospitals are not often keen to supply information about same.”

But, there is some hope according to Hope Rachel Hetico; RN, MHA, CMP™ of www.MedicalBusinessAdvisors.com

“The overall transparency milieu today has definitely improved this last decade as we have participated in CDHPs for all our employees.” 

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Mercer Study Says CDHPs Rising

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HSA / HRA Offerings Jump at Large Employers*

[By Staff Reporters] 

 

2005

2006

2007

2008

Very likely to offer in 2009

Small Employers (10-499 employees)

2%

5%

7%

9%

14%

Large Employers (500 or more employees)

5%

11%

14%

20%

25%

Jumbo Employers (20,000 or more employees)

22%

37%

41%

45%

45%

*Based on either a health savings account or health reimbursement arrangement.

Source: Mercer 2008 National Survey of Employer-Sponsored Health Plans.  www.mercer.com

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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