Healthcare upward cost pressure isn’t going away

DC insider says structural changes have NOT contributed to cost control

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“This evidence supports the Kaiser-Altarum finding that economic declines rather than structural changes in the health sector are primarily responsible for the slowdown in health spending over the past decade.”

Washington DC insider, economics and policy expert and notable authority on Health care economics, Joseph Antos | Testimony before the Senate Committee, July 2013, on the Budget states that structural changes in health care have NOT contributed to the last decade of slowdowns in health care spending.

BCBSM Value partnerships for hospitals

Reimbursement model changes but who is getting the incentives?

Healthcare reform initiated a new payment model that has not widely been discussed. The ACO model in reform allows a hospital, just a for instance, to take a single payment to cover thousands of lives in a geographic area. The management of that population is up to the hospital. ACO is an acronym for “accountable care organization.” You should learn what this means to you.

The Michigan Blue Cross plan is working toward a model to provide “population management” by pulling together new contracts with providers. Providers interested in the “rest of the story” should consider an independent evaluation of these agreements.

Blues Perspective, Four more hospitals agree to BCBSM value-based reimbursement model _ MIBluesPerspectives. From the following BCBSM site link;

Blues Value Partnership, Hospital Pay For Value _ Value Partnerships. From the following BCBSM site link;


Healthcare spend is flat for 10 years

“He also blamed himself and his fellow CEO’s for not demanding payment reform sooner.”

The blog of Dr. Bricker is a good one. He is pointing to improvements in the current healthcare system that will help.

Dr Bricker reports in his blog “Compass,” that one employer for 10 years has flattened the trend. The employer went self-funded, put in CDHP plans, emphasized primary care and set guaranteed rates at a local hospital. These changes, he points out, kept costs flat for 10 years.

Those aren’t the reasons for liking the blog page. The item most noteworthy was the owners self admonition,

“He also blamed himself and his fellow CEO’s for not demanding payment reform sooner.”

Dr Eric Bricker, Compass Blog, May 12, 2014;

Blaming himself and fellow CEO’s doesn’t go far enough, payment reform or the steps he’s pointed to for his own success will never change the overall course in healthcare. We have had four decades or more of increasing healthcare because our “system” does not embrace the notion of lowering healthcare cost.

CEO’s have to step into this arena with the full force of their political, corporate and financial weight if change is going to happen. Here’s one example, many, if not all, CEO’s and Presidents of companies hand-off the annual renewal of healthcare to their staff. Their staff are not equipped for making this decision, and so, rely upon their agent/broker/consultant for information to make the decision.

It is counter-intuitive to expect the system delivering healthcare to cut it’s own cost. Agents/brokers/consultants are paid a percentage of the cost, and they are relied upon to lower it. There are great agents/brokers/consultants who provide needed, valuable service, but they are still selling a product for their existence.

There are levers under the hood that are pushing healthcare costs up and these levers need to be addressed by CEO’s and Presidents.

CEO’s need direction that’s fresh and new, the Owners Health Initiative will provide what’s needed to get at costs and these levers that are under the hood.