By Susan Rupe InsuranceNewsNet
January 21, 2019
A health care
expert predicts 2019 will be marked by a backlash against high deductibles as
consumers fear accessing health care because of rising out-of-pocket costs.
Dave Chase is
co-founder of Health Rosetta, which certifies benefits advisors to help their
employer clients save money on employee benefits by improving the plans they
offer their workers. He also is author of The CEO’s Guide To Restoring
The American Dream.
High-deductible
health plans are going the way of corporate wellness programs and disease
management programs – consumers don’t like them and are pushing back against
them, Chase said.
One reason, he
said, is a blame-the-victim thinking in these plans. “We keep hearing people
say, ‘We’ve got to give everyone skin in the game.’ But the reality is there
are very few tools to be an effective consumer as a patient.”
Part of the
backlash against high deductibles, Chase said, is “20 years’ worth of wage
stagnation and decline.”
Sixty percent of
the American workforce earns $20 an hour or less, according to the U.S. Bureau
of Labor Statistics. With various studies showing more than half of U.S. households
reporting they have less than $1,000 in savings and the national average health
insurance deductible at $1,400, “you’re basically a bad stubbed toe away from
financial ruin,” Chase said.
Even if they have
insurance coverage, people are afraid to access the health care system because
they are afraid of the cost, he contended.
Benefits brokers
are evolving much like stockbrokers did 20 or 30 years ago, Chase said.
“The smart
stockbrokers reinvented themselves as financial and wealth advisors where they
have more aligned interests and more disclosure,” he said. “The challenge with
benefits brokers is that these individuals are meant to be representing the
buyer but they’re paid essentially as a seller’s agent.”
The best way to
slash health care costs is to improve benefits, Chase contended. “So you can
put into place plans that basically boils down to “good decisions – free; bad
decisions – expensive.”
High-deductible
plans have led to more people going the self-pay route in funding care, Chase
said. He also predicted a move away from preferred provider organizations
toward something called a transparent open network.
A transparent open
network offers purchasers such as employers fully transparent pricing for
medical services and procedures ranging from specific treatments (e.g., knee
replacement or colonoscopies) to specific conditions (e.g., diabetes or kidney
disease), according to Health Rosetta’s website.
Services and
procedures are typically bundled, meaning there is just one bill for all the
services received for a specific treatment or condition that includes multiple
providers and sometimes multiple settings. Another dimension of transparency is
that the market is open to participation by any provider with sufficiently
high-quality indicators and charges fair prices.
A transparent open
network offers employers an alternative to traditional fee-for-service payment
models, in which individual services are listed on itemized billing statements
from multiple sources.
“As benefits
brokers put together these plans, they have new tools that deliver much more
value than the PPO networks,” Chase said.
Chase’s advice to
benefits brokers in 2019?
“If you want health
care to cost less, you gotta pay less. We don’t use health care at any
different levels than any other country. We just pay more. We don’t have to.”
Susan Rupe is managing editor for InsuranceNewsNet. She formerly
served as communications director for an insurance agents' association and was
an award-winning newspaper reporter and editor. Contact her atSusan.Rupe@innfeedback.com. Follow her
on Twitter @INNsusan.
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