From the pur­chaser’s per­spec­tive

Providers, in their ex­pe­ri­ence as em­ploy­ers, might of­fer crit­i­cal so­lu­tions

Modern Healthcare - - SPECIAL FEATURE -

send em­ploy­ees to the emerg­ing state health­care ex­changes be­ing formed by the Pa­tient Pro­tec­tion and Af­ford­able Care Act.

The Kaiser/hret study con­firms these ob­ser­va­tions: The per­cent­age of em­ploy­ees en­rolled in plans with a de­ductible of more than $1,000 tripled in the past five years in large va­tions to con­trib­ute to very sig­nif­i­cant chal­lenges ahead for our health sys­tem and our econ­omy. First, they need to be will­ing to raise some tough ques­tions other pur­chasers ask on be­half of em­ploy­ees.

Why are costs ris­ing faster than qual­ity and safety are im­prov­ing?

Em­ployer and em­ployee health costs are up 168% and 160%, re­spec­tively, com­pared with 1999, far ahead of in­fla­tion at 38% and salary growth of 50% dur­ing the same pe­riod. We can­not think of an­other in­dus­try with such steep cost in­creases. In the chance that one ex­isted, it is likely that the in­dus­try could ex­plain its growth re­lated to a sig­nif­i­cant change in the mar­ket or the qual­ity of the prod­uct. How­ever, re­cent data on health qual­ity and safety show nei­ther ap­ply to health­care.

We’ve seen some modest and se­lect im­prove­ments in per­for­mance in the past decade, but lit­tle to no im­prove­ments in an alarm­ingly poor safety record. For in­stance, the 2010 chart re­view of Medi­care ben­e­fi­cia­ries by HHS’ Of­fice of the In­spec­tor Gen­eral found that 180,000

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