What will the health care law mean for employers' insurance plans?

Answer: A lot!

Starting on January 1, 2014, the Affordable Care Act (ACA) requires all health insurance policies sold in the individual market and to small employers to cover minimum essential health benefits (EHB), which include

items and services within at least 10 categories of benefits; no cost-sharing for preventive care; no annual or lifetime limits on coverage; and a minimum “actuarial value” of sixty percent. The EHB requirement is much

broader than what many individuals and small businesses choose to purchase today, which means that millions of people may be required to purchase coverage that is more expensive than they have now.

The ACA imposes a new $100 billion sales tax on health insurance that will add to the cost of coverage for people purchasing coverage on their own, small employers, Medicare Advantage

beneficiaries, and Medicaid managed care programs. The Congressional Budget Office (CBO) has said that this tax will be “largely passed through to consumers in the form of higher premiums.”

Analysts estimate this tax alone “will increase premiums in the insured market on average by 1.9% to 2.3% in 2014,” and by 2023 “will increase premiums 2.8% to 3.7%.”

It Means More _______ and need for a _____

Still with me?

What Can We Do About Rising Costs of Healthcare?

Answer: A lot!

It Means More Bureaucracy and need for a Bureaucractic Killing Machine (BKM)

Reduce variation and use of “hip shoot got with my gut” decision making … invest in the power of analytics, visualization, and smart decision making … work to convert data to info to knowledge to

wisdom … would you rather explain your “hip shoot-gut” or “evidence based” decision?

Improve Patient Adherence through patient engagement, remote health coaching, on-line reminders, and social marketing before, during and after patient visits or encounters .. Patients see their health teams on average 5-6 times for year or 90-120 minutes … how are we helping them in the “white space” with sustained motivation, behavioral change and follow through?

Accelerate implementation of the HER in the federal health system … then use it to conduct studies and analysis to improve quality of care and reduce the cost per capita

Create transparency, incentives, and excitement through ongoing dialogue to enable beneficiaries to be more accountable and make better decisions about their healthcare with innovative tactics,

innovations, gaming, and behavior change strategies

Post the most popular, safe, credible, and free commercial and MHS mobile apps on the organization's web site, then build a long term strategy and social

marketing program to maximize utilization and other apps ….

Invest, encourage, engage, and share knowledge as if it was a precious resource … are you using the Kx to the greatest extent?

Focus on a few disease categories such as diabetes or low back pain to enhance human performance by creating center’s of excellence model starting with analytics to establish a baseline of metrics, generate innovation

through knowledge sharing (Kx), creation of mobile apps, employment of social marketing to engage and activate beneficiaries and patients, encourage use of on line information, e-health subscription services and social

network groups between visits or encounters, and provide intellectual reach back support for health teams …

Comments?

One of the original

AFMSCustomer

Service “Skunks”

Note: the comments made are the author’s own not an official position; references to a company or organization do not represent an endorsement .. you may share this document as free thought leadership knowledge

Col (ret) Doug AndersonDoctoral Student: Health Administration, Central Michigan University

H: 304-263-4405 / C: 703-282-7669On LinkedIn? Yes

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