Company presidents, local CEOs, business owners, managers and other leaders forecast the economic climate for 2015,
including the outlook for their own industry and company.
President, Anthem Blue Cross and Blue Shield in Wisconsin
The perceived lack of progress in health benefits is often met with a common refrain, “We can’t afford more of the same!” Well, in 2016, expect LESS of the same.
With federal health care reform now largely behind us, healthcare provider systems and insurance companies are collaborating to lay the foundation for new models of health care financing and care delivery.
One need look no further than our backyard to see this change; where the provider-system alliances of AboutHealth and Integrated Health Network of Wisconsin (IHN) are busy optimizing their organizations to compete on the basis of value, rather than volume. Delivering care as efficiently, compassionately and affordably as possible is the goal, and these two organizations are to bringing fresh energy and ideas to the market.
AboutHealth is made up of the systems of: Aspirus, Aurora Health Care, Bellin Health, Gundersen Health, Marshfield Clinic, ProHealth Care, ThedaCare,
and UW Health.
IHN is consists of: Agnesian HealthCare, Columbia St. Mary’s, Froedtert & the Medical College of Wisconsin, Hospital Sisters Health System, Ministry Health Care, SSM Health, and Wheaton Franciscan Healthcare.
These two alliances will challenge one another to determine the right quality and efficiency metrics, share best practices within themselves, and use data to identify opportunities for improvement.
So what does this mean for patients? Expect to see more team-based care when you visit a local clinic, such as nurse case managers to help patients with chronic conditions, and mental health professionals embedded on-site to provide timely services.
These kinds of patient-focused changes are being driven by shared savings agreements in insurance contracts, data sharing and analytics. It will take time to fully integrate these tools in the health care system, but all represent a positive move away from the current fee-for-service (do more procedures, get paid more money) reimbursement structure.
Those who stand to benefit most quickly from these changes are businesses with an executive leadership teams fully engaged in their company’s health benefit plans. Stay in close contact with your broker, and always be thinking about how product could replace, compliment or overlap your existing health and wellness offerings. Above all, don’t be afraid to evaluate new products and benefit structures that may be able to deliver sustained improvements in health at a lower year-over-year cost trend.
In health care, less of the same is a good thing. Just don’t bring old mindsets to the table.