HBCH Newsletter July 28 - Transparency Tools, Single-Payer, Plan B

July 28, 2022

Hospital transparency is a key focus area for HBCH. Much local and national attention has been directed towards the price employers pay for hospital services. A majority of employers pay more than 250% of the Medicare price for the same service at the same physician and the prices paid equate to more than 100% of the financial breakeven price for hospitals. The hospital industry is entitled to and must make a reasonable profit to support its community mission. However, employers should not be asked to pay an unjustified healthcare “tax” at the expense of business growth, family quality of life, and resources for other local community needs.

HBCH has provided a resource in the Hospital Transparency section of its website to help all healthcare stakeholders better understand hospital prices and to support future contract negotiations and benefits design. Contact chris.skisak@houstonbch.org if you need support to navigate any of these tools.

RAND Hospital Price Transparency – provides a comparison of what the employer pays for hospital services compared to the price Medicare pays that same hospital and provider for the exact same services.

National Academy for State Health Policy Hospital Cost Tool – provides state policymakers and researchers with analytical insights into how much hospitals spend on patient care services, and how such costs relate to the hospital charges (list prices) and actual prices paid by health plans.

Sage Transparency Dashboard – provides price and quality information from multiple sources in an easy to understand and view format.

If U.S. healthcare delivery is to be transformed to a population outcomes-based value model employers must be ready to demand change. Value in this case includes price and total cost of care in the equation. Collectively employers have been reluctant to question the value of employer-sponsored healthcare. In its absence it may be just matter of time before we transition to single payer.

So, with that in mind, what would a single-payer system mean to the U.S. economic engine? An article in the Harvard Business Review makes the case for the end of employer-sponsored healthcare and the creation of a single-payer system. The authors describe the current system as a burdensome and unnecessary tax on corporate America. No other developed country imposes anything close to such a heavy “health care tax” on its businesses. The article provides empirical data to support single-payer impact on wage growth, consumer demand, balance of trade and state and local government budgets.

Maybe Plan B is the Answer

In lieu of transitioning to a single-player, there is another alternative. In his July 11 report Paul Keckley provides thoughts for consideration in light of the recent American Hospital Association Leadership Summit in San Diego. He states that most hospitals recognize their future is not a repeat of their past and provides a perspective on the likelihood of Plan A (the current mode) or Plan B.

Plan B design features reflect three major changes:

• The integration of public health with health delivery….regional systems of health.

• The integration of financing and delivery of care….aligning costs, prices, and competition based on value.

• The integration of self-care in care management….accountability for consumer behaviors.

The Healthcare Digital Dilemma

Wednesday, September 21, 8:00 am - 11:30 am CST -

The Friedkin Group

1375 Enclave Pkwy, Houston, TX 77077

REASONS TO ATTEND

· Learn how digital technologies are transforming delivery

· Learn what to expect in terms of cost reduction and outcomes

· Learn how others support and enhance traditional in-person care