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This week on ShiftShapers, we wrap up our two-part discussion with Brooks Goodison, President of Diversified Group.  Last week, Brooks helped us sort through the changes underway that target groups that want to move away from fully-insured plans. This week, he highlights strategies that employer groups are using to fight the rising cost of health care as a result of the Affordable Care Act.

Health care expenses can easily become one of the largest expenses for families and the rising costs have a direct impact on a consumer’s ability to plan for their financial future. Given this reality, employers are actively looking for ways to control health care costs. Brooks points out the pros and cons of reference-based pricing and provides case studies on how these programs compare to traditional PPO contacts.

He also clarifies whether allowing consumers to purchase health care across state lines will produce tangible savings. Is this just an election year talking point or can this strategy actually bring down costs without sacrificing health care quality?

What You’ll Learn From this Episode:

  • An introduction to reference-based pricing.
  • How widespread reference-based pricing is today and whether it will gain traction.
  • Whether reference-based pricing could fundamentally change our notion of “networks”.
  • Why politicians keep talking about selling across state lines.
  • The new techniques and challenges with employee engagement.

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A quiet battle at the state level may make it more difficult for you to be creative in the small and mid-market spaces.

In this week’s episode, Brooks Goodison, President of Diversified Group joins us to discuss how renewed interest in partially self-insured plans in the small to mid-market has drawn the attention of state regulators. In this first segment of a two-part discussion on ShiftShapers, Brooks helps us sort through the changes underway that target groups that want to move away from fully-insured plans.

New York, Maryland, Connecticut and other state regulators are changing stop-loss insurance regulations in ways that would severely impact the number of employers able to take advantage of partial self-insurance options. Some believe that these regulatory moves are nothing more than an attempt to force membership into state exchanges. Others believe that only large and jumbo groups should be permitted to partially self-insure.

Employers looking for strategies to move the needle on healthcare costs will find this discussion valuable. The ACA and other external pressures are forcing groups to look carefully at all options. This episode highlights technology that can help employers with better decision making and control cost without sacrificing health care quality for employees.

 

What You’ll Learn From this Episode:

  • Why the renewed interest in self-funding is drawing the states’ attention.
  • How the general election is apt to affect this incursion.
  • What private exchanges are and whether they are a new panacea.
  • The latest strategies and tactics to move the needle on costs.
  • How TPA can become a strategic partner with an advisor generalist.

Featured on the Show:

Listen to the Full Interview:

This Episode is Sponsored by:

Enjoy The Show?

Subscribe-with-iTunes-smallSubscribe-with-Stitcher-smalliHeartRadio-small