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As GOP Looks To Drag Health Care Backwards, Health Insurers Look Forward


Recently, Congressman Steve Chabot of Cincinnati, Ohio wrote on his blog, "I haven’t seen so much misinformation and hysterics about a piece of legislation in a long, long time—maybe ever" about the passage by the House of the American Health Care Act (AHCA). I guess he was asleep during the passage of the Affordable Care Act (aka Obamacare). But all kidding aside, I strongly suspect that the Senate will continue the House's work to make American health care look more like it did pre-Obamacare. They never thought health care reform was necessary in the first place.

Republicans have the numbers to pass the health care bill they want; still, I can't help but think that a return to the status quo is not in the country's future, at least not long-term. You see, Republicans may think that they are about to accomplish something that's never happened before, taking away a huge federal entitlement program, but not even health insurers are prepared to return to the bad old days. Insurers know they passed the big-changes-are-coming-moment and are in the redefining-and-refining-our-purpose-moment, and if the GOP had consulted them during the health care reform debate, they would know this also.

What Health Insurers See As Their Future

Optimizing value by providing doctors with data analysis services.
Last week Humana's CEO, Roy Beveridge, described the country's third largest health insurer as
an IT company focused on data analytics to improve health care value. According to Beveridge, the future of health care may be using data to understand risk better and sharing this data with doctors to improve patient outcomes. Doctors can use this data to determine which patient populations need what care and how often to engage with them.

Focusing in on getting a bigger piece of the (new) pie.
Also, last week, health insurer Aetna, Inc.,
announced it would pull out of the Obamacare exchanges for next year. In addition, Aetna CEO, Mark Bertolini, reportedly said, the country needs to have a conversation about single-payer health care. However, instead of health insurers competing with the government to offer health insurance, Bertolini envisions health insurers managing the single-payer program for the government, as it does with Medicare and Medicaid.

Enhancing patient access to health care services.
The Blue Cross Blue Shield Association is looking to help the very population the AHCA would possibly harm, the poor and isolated. Recognizing that not everyone has access to reliable transportation to get to non-emergency medical appoints BCBSA is
piloting a program to partner with Lyft to provide free rides to its members. Continue Reading...

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The Real Costs of Employer-Sponsored Health Insurance



The majority of Americans hate health insurance companies. They blame them for all that is wrong with the health care system in the country, but mainly its costs. But insurers do not deserve all, or even most of the blame for what ills American healthcare. There are other culprits including the medical, pharmaceutical, and medical device maker industries, politicians, policymakers and regulators. Employers and the American public are also to blame.

If health insurance companies are an extra cost layer in the health care cake, than so too are employers. They add costs to the health care system that receives little or no notice. Sure we talk about some of the costs of workplace health insurance, like the hundreds of millions of dollars in loss tax revenue due to the favorable tax treatment of these plans. And how these employer and government-subsidized plans leave workers with little skin in the game and no appreciation of the real cost of health care. But there are other costs that employers add to the country’s total health care bill that, if eliminated, could save a lot of money.

The Problem(s) With Employer-Sponsored Health Insurance

Employer-provided health insurance provides complexity to the health care system and, therefore, increases its costs. Because of the legislative and tax status of these plans, they require a regulatory system to monitor their compliance. The government hires attorneys and other specialists to perform these tasks. Also, because of their need to comply with government regulations, plan sponsors (employers) hire lawyers, consultants, brokers and other technical specialists to keep their plans in compliance and meet reporting and testing requirements. Employers also hire internal staff to work with the lawyers, consultants, brokers, etc.
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