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Barriers to Reducing and Controlling Healthcare Costs

Soaring healthcare costs combined with the economic downturn pose a significant challenge for employer-sponsored health plans that cover medical costs for 61 percent of the U.S. population.

In 2011, health premiums will continue to surge upward with most major surveys projecting increases in the 9 percent to 12 percent range – or over eight-times the rate of inflation. Without change, the Business Roundtable, an association of major U.S. corporate CEOs, predicts employer health costs will increase 166 percent by 2019, resulting in a cost burden of $28,530 per employee – three-times the 2009 employee cost of $10,743.

In this environment, employers – major payors of the $2.6 trillion annual U.S. healthcare bill – are under enormous pressure to find out where their benefit dollars are going. These same employers are focusing on how they and their workforce are able to get the best value for the money spent on healthcare.

Employers seek answers to questions such as:

  • What steps can I take to identify and mitigate my healthcare expense trend?
  • What areas are showing the highest potential for costly future medical risks?
  • What proactive steps can be taken to control costs and improve employee health behavior?

This research report provides an overview of the data and tools needed by employers to interpret relevant plan data, find the problems and determine solutions. It also addresses the basic obstacles and ‘hidden’ barriers to employer healthcare control and the opportunities to overcome these barriers with collaboration between employers and gatekeepers – consultants, brokers and insurers – for improved health plan performance.

Click here to download a complimentary copy of this Healthcare Performance Management Institute report. (Complimentary site registration required.)

Want to learn more?

Listen to our recent StrategyDriven Editorial Perspective podcast interview with George Pantos, Executive Director of the Healthcare Performance Management Institute during which we discuss how companies can keep their current health plans in light of the recently passed healthcare legislation and under what circumstances they may wish to do so.

Breaking Down Health Reform’s Grandfather Clause

New Rules May Hamstring Employers’ Ability to Innovate Existing Plans…

The grandfather clause is a provision in the Patient Protection and Affordable Care Act that seeks to keep a key promise made by the Obama administration: “If you like your health care plan, you can keep your health care plan.” But interim final rules handed down by the Department of Health and Human Services (HHS) and other federal agencies June 17, 2010, appear likely to frustrate the intent of the law and hamstring employers’ ability to offer the best coverage options in a cost-effective manner. In adopting an overly restrictive interpretation of the grandfather clause, the rules essentially diminish employer flexibility to make plan design changes by tying allowable changes to current plan structures.

A new report by the Healthcare Performance Management Institute examines the grandfather clause, the new HHS rules that will govern its implementation and the likely impact on employer health plans. The report also addresses factors organizations should consider when deciding whether or not the benefit of retaining grandfather status outweighs making certain plan design changes.

Click here to download a complimentary copy of this Healthcare Performance Management Institute report.

Want to learn more?

Listen to our recent StrategyDriven Editorial Perspective podcast interview with George Pantos, Executive Director of the Healthcare Performance Management Institute during which we discuss how companies can keep their current health plans in light of the recently passed healthcare legislation and under what circumstances they may wish to do so.

StrategyDriven Podcast Series

StrategyDriven Editorial Perspective – Reengineering Healthcare

StrategyDriven Editorial Perspective podcasts examine the unnecessary marketplace uncertainty created by today’s headline events and the actions business leaders should take to ensure their organizations succeed under these circumstances.

In Reengineering Healthcare, we are joined by Jim Champy, author of Reengineering Health Care: A Manifesto for Radically Rethinking Health Care Delivery. Jim shares his thoughts on the recently enacted healthcare law and what business leaders can do to help promote better health and wellness among their workforce, including:

  • the fundamental issues with our current healthcare system and whether the recently passed healthcare reforms will adequately address these challenges
  • how reengineering can lead to more efficient, safer delivery of healthcare services
  • the role business leaders should play in reengineering the healthcare system
  • methods leaders can use to promote wellness within their workforce

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About the Author

Jim Champy, author of Reengineering Health Care: A Manifesto for Radically Rethinking Health Care Delivery, is Chairman Emeritus of Consulting at Dell Services. He is recognized throughout the world for his work on leadership and management issues and on organizational change and business reengineering. Jim’s first book, Reengineering the Corporation: A Manifesto for Business Revolution, sold more than 3 million copies and spent more than a year on The New York Times best seller list. He also authored the best seller, Reengineering Management: The Mandate for New Leadership, which was recognized by Business Week as one of the top ten best business books of 1995. His columns and articles appear in such magazines a Forbes, ComputerWorld, Sales and Marketing Management, Leader to Leader, and Baseline. To read Jim’s full biography, click here.