BOSTON, Nov. 24 -- If you ask Eric Kasen, Vice President and principal of the New England office of Hays Companies, America's national healthcare conversation has been held as if there were only two stakeholders with skin in the game: consumers and insurers. Unless the U.S. switches to a single-payer plan soon, employers have as large a stake in healthcare reform as any player.
Hays Companies, the nation's second largest privately held employee benefits broker and consulting firm with an office in Boston, is tackling critical issues in the healthcare debate seldom addressed by other sources, including Metrics-Based Health Plan Decision Making, Population Health Management, and Risk Pool Management.
"As an advocate for companies trying to do right by their employees, I'm dismayed by proposals from Washington," said Kasen. "They either tinker at the margins or ignore the elephants in the room… big issues responsible for driving up healthcare costs, such as providers' irresponsible business models and patients' irresponsible behaviors."
Kasen believes the nation needs game-changing, long-term initiatives for the healthcare system. Implemented in concert with such immediate changes as eliminating pre-existing condition clauses, these initiatives can rein in costs, improve patient care, and encourage a healthier citizenry:
Regulate provider compensation based on the quality of outcomes rather the quantity of services. Changing compensation from fee-for-service to an outcome-based model aligns the physician and patient's interests. Some of our finest medical institutions, such as the Mayo Clinic, already operate under this model.
Offer financial incentives to medical students to become primary care physicians. Too many specialists and not enough family doctors creates a glut of expensive services that drive up healthcare costs. Family physicians are the lowest paid -- and the most important -- segment of the medical field. Providing financial incentives to talented young students to become primary care or family physicians would go a long way toward balancing the scales.
Put a reasonable cap on medical malpractice claims as federal law. Disproportionately punitive malpractice claims have led to two negative trends: 1) Physicians avoid key specialties to avoid the effort and expense of protecting themselves from lawsuits. The cost of malpractice insurance, as well as the scarcity of providers in these specialties, dramatically increases the cost of patient care. 2) Doctors are tempted to practice "defensive medicine" to ward off malpractice claims, ordering uncalled for tests and procedures.
Create a uniform electronic national medical records system. Some hospitals are already improving the speed and quality of care using e-records to exchange such information as relevant test results, doctors' notes, and hospital records, but the practice needs to be extended nationwide.
Require healthcare plan subscribers to receive an annual physical. Patients simply must assume more responsibility for their health. Hays Companies' data analysis shows the majority of U.S. employer plans spend less than 2% of their claims on adult physicals, and more than 38% on chronic health issues such as Type 2 diabetes and high blood pressure. These preventable or manageable diseases can be caught early by primary care physicians during annual physicals.
Tax unhealthy behaviors, like smoking, alcohol, and sugary drinks. Reckless drivers pay more for their auto insurance because their behaviors are costly and avoidable. Shouldn't the same hold true of consumers' healthcare expenses?
These proposals attack long-standing practices and ask everyone to give a little, but today's healthcare system is so broken it cries out for bold changes from providers, insurers, employers, and employees alike.
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Eric Kasen
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SOURCE Hays Companies
