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4 key factors for effective health plan decision support

There are no silver bullets and the health system as structured today cannot pivot effectively. But there are some strategies that can immediately influence cost trends.

By Tim O'Shea | Updated on August 23, 2016
Picking the right plan can save employees significant money, often hundreds or thousands of dollars annually. Photo: Getty Images.

For decades, the health insurance industry has worked, mostly unsuccessfully, to slow the pace of increasing cost. The complexity of our medical delivery system makes the task daunting, given complex care delivery models, misaligned incentives and payment methods, the pace of technological advances, and society’s preference for broad provider network access. In recent years, cost containment initiatives have focused largely on advancing consumerism to buck the trend, nudging individuals to be more responsible for navigating the market, and providing tools intended to help them do so. 

Some consumer tools have had immediate impact; others are and will continue to be slow to contribute to controlling cost.  Telemedicine, for example, holds promise across multiple specialties, but applications that simply ease access to primary care services and provide consumer convenience may not really reduce system cost.  Cost transparency tools theoretically align well with consumer driven health plans, but the underlying maze of health delivery and provider reimbursement arrangements challenges the near term value  these tools  offer for many procedures or conditions. In summary, there are no silver bullets and the health system as structured today cannot pivot effectively. 

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