Employer-Designed Health Plans Gain Traction
July 15, 2009 -- President Obama might want to take a serious look at how Oregon insurers and employers intend to transform healthcare in 2010.
Many of his ideas have been incorporated into the work of a local group known as the Health Leadership Task Force – bending the cost curve, relying on evidence-based medicine, reducing financial barriers to chronically ill people and supporting prevention and wellness to create a culture of health.
- People with chronic conditions will pay no deductibles and be charged only a minimal co-payment to manage their care. By reducing financial barriers, fewer people will seek emergency room care or require hospitalization. The list includes depression, diabetes, asthma, congestive heart failure, coronary disease and chronic obstructive pulmonary disease.
- People will pay much higher deductibles, co-insurance and co-payments for healthcare services that offer little clinical value and are driven by provider preference or supply. The list includes spinal surgery for pain, shoulder surgery for osteoarthrosis, knee arthroscopy, knee and hip replacements, hysterectomies, coronary artery bypass grafting, upper endoscopies, visits to the emergency room and imaging tests – MRI, CT and PET.
- All other services would fall under the standard deductible, co-insurance and stop loss provisions.
Besides working on the value-based design, Honzel is coordinating efforts that focus on evidence-based practices, payment and reimbursement reform and administrative simplification.