Congress waved the white flag on healthcare reform again last week, and swiftly moved on to tax reform. Perhaps they’re finally ready to admit what CFOs and HR executives have known all along—health care is a tough nut to crack.
Every year employers across the U.S. struggle with balancing costs and benefits, hoping to maximize efficiency in their plans while focusing on the very real human element that people’s lives and livelihoods are at stake. As the public exchanges become increasingly anemic and costly, any employer sponsored health plan looks more attractive from both a provider network/ access and cost standpoint.
But employers are quickly positioning to deal with this new risk. Emerging market strategies such as narrow networks and reference-based pricing will likely surge in popularity. The focal point will – correctly – be on the supply side of the equation. While offering employees transparency tools/cost comparisons has proven to be helpful on small dollar claims, the bulk of employer costs continue to be in the large claims/specialty Rx areas – where transparency tools can’t direct care effectively.
It is in this market where companies like Imagine Health have emerged. The pitch is simple and familiar: Narrow the network/access based on quality and costs and secure up front savings for the employer. Time will tell, but this “new” approach seems more likely to bend the curve than asking employees to help price shop for their own care.