bswift Roundtable Takes on Trillion-Dollar Question: How to Provide Quality Health Care for Less Money?: bswift Blog


bswift Roundtable Takes on Trillion-Dollar Question: How to Provide Quality Health Care for Less Money?

by Don Garlitz, Senior Vice President, bswift

December 15th, 2015

It was a nice change of scenery (and temperature) to travel from Chicago to Los Angeles on December 4 for our roundtable discussion about the impact that technology can have on ACA compliance.

As a backdrop to the discussion, I shared several data points from our latest Benefits Study—specifically employer attitudes and adoption rates regarding defined contribution health care solutions and private insurance exchanges, high deductible health plans and workplace wellness programs. All of those plan designs and health promotion programs have grown year over year, not coincidentally, in tandem with increasingly complex ACA mandates.

As employers work to achieve greater cost savings overall, and specifically lower the costs of their plans to avoid the 2018 Cadillac tax, it seems any and all solutions are on the table—some of which the attendees, speakers and I discussed last week at the roundtable.

However, as I said in my remarks: “Whether we have a Cadillac tax or not … what we’re really trying to do here is figure out how to make health care less expensive. It’s not just about helping people select less expensive plan designs; [it’s about] how to provide quality health care with less money.”

A potential solution is to further explore the ACO (accountable care organizations) strategy, which shifts American health care away from fee-for-service and into value-based reimbursement. Forward-thinking employers are doing more and more with ACOs to tie provider payment to quality, not quantity— we’re glad to lend our expertise to help them expand those opportunities.

As we navigate ACOs and other cost solutions, I was glad to share the podium with James Napoli, a partner in the employee benefits practice at D.C.-based firm Seyfarth Shaw. James offered insightful comments on some of the potential consequences, intended and unintended, that may go along with a significant change in plan or policy.

“Knowing human beings and the way we tend to think, I think we’ll see the same issues on the defined contribution health side that we’ve seen on the defined contribution retirement side—and those issues are worth looking into,” he said. “There’s no plan design out there that allows you to completely wash your hands of this—other than just to say, ‘We’re not going to provide health care.’”

While I’ll grant you that there’s nothing about providing health care benefits that’s easy, especially regarding ACA compliance around Form 1095 and other mandates, walking away altogether isn’t consistent with what we know employers believe is best for employees or their businesses. As I said at the roundtable, outside of helping employees navigate plan choice, “there’s a good deal of savings opportunity that happen post-enrollment [including social wellness, transparency tools and telemedicine]. I know many of you are engaged in those as ways to cut costs, and I admire those efforts.”

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