Innovation in the supply side and financing of employer-sponsored health plans

Highlights from our session include Dr. Christine Hale, V.P. of Clinical Consulting for Lockton Dunning, explaining innovative strategies to manage/mitigate risk from complex claims. These strategies can shave many millions of dollars off an employer’s healthcare spend. One of these strategies is Lockton’s unique relationship with the world-renowned Mayo Clinic in Rochester, MN, whose physicians assist in clinical review of complex treatments and high-dollar claims facing clients. This medical/consultant partnership translates to higher quality and more cost-effective care for patients.

We also discussed new gene therapies and “specialty Rx” costs hitting health plans today. While these treatments provide a clear benefit to members, the costs/risks posed to many employers are difficult to spread out across the majority of mid-sized self-insured health plans. The volatility and cost are simply too high for some plans to absorb. As a result, there are many people working to create purchasing/funding solutions for these high Rx costs, which will bring innovation to this market and ensure that patients can continue to receive the best care for their conditions. This recent article from Modern Healthcare details how some insurance carriers/TPAs are creating cost-sharing platforms to remove volatility for small to mid-sized employers.

I look forward to presenting at Duquesne again, and partnering with other universities to talk about the current and future state of our healthcare system.