Don't just pop balloons, Tim! What are your ideas?

How do we increase access to health care at a reasonable cost?

Reference-based pricing on out-of-network claims instead of paying billed charges
Health plans walking away from network arrangements and using reference-based pricing across their benefit structure
Direct primary care as a pre-paid solution, at a set rate, with high access
Direct contracting/regional networks with competitive rates built in and skin in the game for all parties
Robust subrogation programs to seek out 3rd party dollars and place those dollars back into an employer-sponsored health plan's pocket to be reinvested / utilized for growth etc.
Educated plan design using responsible pre-certification requirements
Promote member consumerism through financial incentives built into your health plan – waive patient responsibility for select facilities; give patients a percentage of savings when they discover billing errors; provide medical tourism options
Explore innovative solutions through employer sponsored, self-funded health plans

In short, the solutions are already before us and the solutions for increased access at a reasonable cost sit in the hands of innovative employers willing to explore unique plan structures within their self-funded health plan environment.

Instant Insights /

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