Don’t over­look im­pact of con­sumer-driven healthcare

Modern Healthcare - - COMMENT -

Re­gard­ing the re­cent Com­ment/Guest Ex­pert, “Higher em­ployee cost-shar­ing could un­der­mine job-based cov­er­age sys­tem” (Mod­ern Healthcare, June 8, p. 25), the Com­mon­wealth Fund’s Dr. David Blu­men­thal ad­dressed many salient facts and is­sues re­lat­ing to em­ployer-based health in­sur­ance in his ed­i­to­rial.

While he is spot on in his assess­ments on many fronts, he ne­glected to dis­cuss con­sumer-driven healthcare and the im­pact it has on healthcare cost-shar­ing among em­ploy­ers. Em­ploy­ers are shift­ing costs, in part, to cre­ate in­cen­tives for their em­ploy­ees to en­gage in value-based de­ci­sion­mak­ing. To sup­port that, they are in­vest­ing heav­ily in strate­gies and tools to in­form em­ploy­ees’ de­ci­sions. And although the Af­ford­able Care Act now man­dates full cov­er­age for pre­ven­tive ser­vices, many em­ploy­ers al­ready of­fered it.

Amer­ica’s lead­ing com­pa­nies have been in­stru­men­tal in driv­ing pol­icy aimed at im­proved trans­parency, out­comes and value-based healthcare. Many of the na­tion’s largest cor­po­ra­tions have im­ple­mented ben­e­fit de­signs and healthcare pro­grams that move the mar­ket. For in­stance, some em­ploy­ers do se­lect con­tract­ing for com­mon and ex­pen­sive pro­ce­dures such as hip and knee re­place­ment and spine surgery for bet­ter qual­ity and sav­ings, in­clud­ing sav­ings for em­ploy­ees.

It helps ev­ery­one—em­ploy­ers and their cov­ered mem­bers—to do busi­ness with value-based, out­comes-driven healthcare providers.

Many would con­clude that some of the cost-re­duc­tions Dr. Blu­men­thal ref­er­ences are at­trib­ut­able to con­sumer­driven health plans. That said, em­ploy­ers do not think it’s good ethics or sound busi­ness to cause un­due fi­nan­cial bur­den for em­ploy­ees and they rec­og­nize they need to—ei­ther di­rectly or in con­cert with health plans—re­duce the over­all cost arc of healthcare.

Lau­ren Vela Se­nior di­rec­tor of mem­ber ser­vices Pa­cific Busi­ness Group on Health San Fran­cisco

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