HBCH Newsletter February 2: Employer Survey on Health Care Plan, Texas Bill on Healthcare, Tension Between Insurers and Hospitals

Employer Survey on Health Plan Value

The Leapfrog Group conducted a national survey of employers in late 2022 to benchmark employer satisfaction on health plan value.

Employers rate their experiences in four areas:

Responsiveness of the health plan to employer concerns
Transparency in helping employers and employees choose the best providers
Payment reform initiatives that incentivize excellence in the market
Value strategies driven by health plans

Key findings included:

A grade of “C” on ability to provide high-quality healthcare
Employers (agree/strongly agree) that their health plan
Cares about quality of healthcare received (57%)
Is committed to reducing costs (53%)
Offer alternative payment models (29%)
Shares quality & safety data (26%)

A webinar featuring benefit directors from major U.S. corporations to discuss results was held last week.

Texas Bill Hoping to Make Healthcare a Market Again

Will Maddox, editor for D CEO Healthcare, published an article last week about a bill that has been introduced before the 88^th Texas Legislature.

Representative James Frank wants to make health insurance contracts more competitive and transparent in Texas. The Wichita Falls legislator has introduced HB 711 to end some practices he says increase costs for employers and workers. Horizontal consolidation by the health plan and hospital industries makes regulatory support as the only option to recreate a competitive market.

Frank has an intimate view of how health insurance contracts work as CEO of Sharp Iron Group, a contract manufacturer in Wichita Falls with 180 employees. “There’s nothing else in this country that if we were getting 50 cents of value for every dollar that we spent, that it would be OK,” he says. “Companies wouldn’t be OK with that.” But in his opinion, that is what was happening with healthcare. There are plenty of cost centers for healthcare, but Frank’s bill is focused on healthcare contracting and being able to steer patients toward facilities that maintain good results without exorbitant costs.

HBCH is supporting employes through its advocacy through Texas Employers for Affordable Healthcare. Employer support and its collective voice in Austin will be critical as opposition to this long overdue transparency will be strong. Please TAKE ACTION TODAY!

The Escalating, Ironic Tension Between Insurers and Hospitals

Paul Keckley is managing editor of The Keckley Report, a healthcare policy analyst, and widely known industry expert.

In his January 9 report he commented that “Blistering attacks on hospitals were a staple in media coverage in 2022. Comparatively, health insurers escaped unscathed.”

However, he reports of mounting tension between hospitals and insurers. It has its roots in deeply-held beliefs about the health system and the roles each should play. Boundaries between the two have been breached: more than 200 hospitals now own all or part of a captive insurance plan and every national insurer operates clinics with employed clinicians and ancillary services. Both recognize their markets are changing and demand for their core businesses is shrinking (insurance risk, inpatient care).

Add to this mix a decreased public trust and confidence per a Gallop 2022 poll:

72-78% of US adults across all income groups assign D or F grades to the US health system
32% of US adults are “cost insecure” about their healthcare needs
79% favor federal limits on health insurance premiums and 76% favor federal caps on hospital prices

The near-term tension between hospitals and insurers will continue as affordability and transparency concerns mount. Keckley believes more aggressive risk sharing agreements will be common for employers.

NOTE: HBCH continues to work with local providers to develop a Smart Network for Houston for employees to select as an option to existing PPOs. The Smart Network with an Advanced Primary Care foundation and PCP referral to specialists based on value (quality and price) will substantially lower the cost while improving employee satisfaction. Contact info@houstonbch.org for more information.