In recent years you say?
Not sure how the writer of this defines “recent years,” but employers have been trying these and other strategies at least back to the early 1980s … thirty-seven years and counting. Guess what? We are still agonizing over health care costs.😰
After HMOs and high-deductible plans, employers are eyeing the next bid for value. In line: Narrow provider networks. HMOs, tiered networks, high deductible plans and moving care away from hospitals to lower-cost outpatient facilities are among the bids by payers and employers in recent years to drive quality for the best price.
Most employers haven’t pulled the narrow network lever yet despite payers finding success in the Medicare Advantage (MA) and Affordable Care Act (ACA) exchange markets. Employers move more slowly with new insurance models, but seeing effective government programs could prod them to take the leap.
I began managing health plans in 1961 and until around 1975 we didn’t care much about costs; they were quite modest in fact. Thereafter we “improved” the plans, negotiated added benefits, added choices, prescription drug coverage and more. We all know hat happened then and is still happening.
In the mid 1980s the direction changed. Now the game was controlling costs, shifting out-of-pocket costs to workers and raising their premiums.
And here we are still doing all the same things and more … except politicians decided that even more coverage should be added actually believing, or telling us, the changes save money. 🤪
The biggest mistake we make is believing that health care costs are premiums and ignoring the cost of care, the use of care and the type of care we receive … and how much of that care we cause by our behaviors.
Here we are making a big deal about making changes around the edges, others pushing for a single-payer system and most people having no clue about what it takes to manage health care costs.