|
LAKELAND, Fla. – Reform measures as currently proposed cannot fix the nation’s broken healthcare system because they fail to address the core problems: lack of free market competition and the failure of wellness initiatives to reduce the prevalence and severity of chronic conditions, which consume the majority of healthcare dollars.
That is the message Chandler J. Rapson, CEO of First Service Administrators, Inc. (FSAI), a leading third party administrator for hospitals, healthcare systems and public entities, is urging the benefits administration industry to send to policy makers before it is too late.
“Restoring free market competition by ending monopolies that create situations like we have in Florida, where two carriers control nearly 90% of the state’s health insurance market, as well as passing ‘any willing provider’ legislation and mandating transparency is critical to fixing what is broken in the system. Equally critical is coupling insurance reform with truly effective wellness programs that encourage personal responsibility and accountability,” said Rapson. “Unfortunately, because these key issues are not addressed, current healthcare reform efforts are little more than subsidized coverage. They are doomed to fail and will cost taxpayers dearly in the process.”
Echoing the fixes highlighted in “The Six Ways to Fix Our Healthcare System,” a healthcare reform position paper issued in July by AmWINS Group Benefits President Samuel H. Fleet, Rapson called upon policy makers to focus reform efforts on:
• Restoring free market competition: In addition to ending monopolies by individual carriers, which typically control 80-90% of a market, healthcare reform must address the need for transparency in the provider contracting process and mandate that networks be open to any provider willing to accept the same terms as those already in networks. It must also include price standardization and publication of quality ratings in meaningful, user-friendly formats. “It goes beyond leveling the competitive playing field,” said Rapson. “Healthcare reform must eliminate the monopolies that have carriers focused more on profits and locking out competition than on ensuring that their provider networks deliver quality care. It must pave the way for consumers to choose their payers and providers based on quality and preference rather than price.”
• Implementing effective wellness initiatives: With chronic conditions now affecting 125 million Americans and consuming 75% of the nation’s $2 trillion in medical costs, it is clear that the wellness programs offered by 90% of private health plans are failing to drive necessary change in consumer behaviors. By following a proven model that utilizes predictive modeling, early intervention and personalized education and support coupled with meaningful rewards and penalties, wellness programs can succeed at driving down the costs associated with chronic conditions. “It’s about incentivizing consumers to assume personal responsibility for management of their health,” said Rapson. “By giving them the tools and holding them accountable for their behaviors, consumers will respond by making the lifestyle changes necessary to positively impact their health.”
For example, the wellness programs offered by FSAI utilize predictive modeling to analyze employee populations and identify excessive healthcare costs and their drivers. Best-of-class risk management tools and cost containment strategies are then utilized to reduce a client’s overall healthcare spend. Health risk assessments and personalized wellness communications are also provided to motivate employees and promote healthier lifestyles. The results are improved compliance with
Show all News |
