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Mercer

This has been a busy week for healthcare in DC -- and the week’s not over yet! On the heels of the leaked Republican reconciliation bill language last Friday (that is already being described as out of date), the governors arrived over the weekend for a National Governors Association meeting that included dinner at the White House on Sunday. While the President tweeted that they “might” talk about healthcare, you can be sure the future of the Medicaid program and, more specifically, Medicaid funding, was at the top of the governors’ list of topics. Certainly, the 31 states that expanded Medicaid fear the funding implications of a block-grant program.

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Your new employee is 26 years old. He’s rarely sick -- maybe some occasional weekend-warrior soreness. His biggest health expense is his refrigerator full of grape Mountain Dew Kickstarts.

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This post is part of our “Driving Transformation” series, in which Mercer consultants share key take-aways for employers from the 2016 Oliver Wyman Health Innovation Summit, a recent conference hosted by Mercer’s sibling firm, management consultant Oliver Wyman.

 

In this blog post, Oliver Wyman’s Terry Stone discusses how to fix the healthcare consumer experience. Despite abundant effort to address the industry shortcomings, she asserts that we haven’t spent enough time addressing the root-cause issues. Success lies in understanding the consumers’ needs and solving their problems. More than ever before, healthcare consumers expect us to stop making the complexity of the system their problem. So the next time you are addressing a change to your health plan, ask if the change makes it easier for your employees to access the right care at the right time.

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This post is part of our “Driving Transformation” series, in which Mercer consultants share key take-aways for employers from the 2016 Oliver Wyman Health Innovation Summit, a recent conference hosted by Mercer’s sibling firm, management consultant Oliver Wyman.  

 

The rise of the consumer has already caused a seismic shift in the strategic direction for most hospitals and health systems. These providers recognize the imperative to find new and different ways to demonstrate value across the care delivery continuum. This means focusing attention on what consumers of most products and services look for: cost, quality and an engaging and convenient experience. Integrated clinical and commercial strategies must be developed to successfully address each of these elements.  With increased focus on improving population health and patient satisfaction, re-thinking how multi-generational consumers access healthcare providers will be critical to future success. There will be various patient-centric “front doors” to healthcare, including retail health, telemedicine, onsite clinics, digital health, care navigation and a re-invented doctor’s office experience.

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This post is part of our “Driving Transformation” series, in which Mercer consultants share key take-aways for employers from the 2016 Oliver Wyman Health Innovation Summit, a recent conference hosted by Mercer’s sibling firm, management consultant Oliver Wyman.  

 

A session focused on the power and promise of genomics was of particular interest to employers at the conference. Industry leaders discussed how genetic testing has now passed the price-vs.-utility intersection, making genetic assessments a potentially powerful tool to better identify health risks and target treatment for particular conditions. 

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The IRS has released draft instructions for 2016 Forms 1094-B and 1095-B, confirming that health insurers and self-insured employers can expect few changes when reporting minimum essential coverage (MEC) provided to individuals in 2016. The Service posted preliminary 2016 versions of these forms in June, but instructions noting what's new became available only last week. The IRS uses data from this reporting to administer assessments under the Affordable Care Act’s individual mandate provisions. Separately, the IRS earlier released draft 2016 employer shared-responsibility forms and instructions that applicable large employers will use to report coverage offered to employees and their dependents.  

 

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This interesting piece in Kaiser Health News sheds some light on a real gap in healthcare: Physicians are barely trained in medical school on how to identify and treat addiction. In fact, only a few hours in the course of four years of medical school are devoted to teaching addiction medicine. Schools have been so slow to change that medical students at Harvard University, for example, have started conducting their own training on how to buy and administer drugs that reverse the effects of an overdose. And Stanford’s medical school adjusted its curriculum so that lectures on addiction will no longer be folded into the psychiatry series as a side note, but instead will be presented as a separate unit, relevant to future doctors in any subspecialty – and that training will continue when the students leave the classrooms for clinical rotations. As the story notes, medical schools have traditionally avoided teaching about addiction, partly because so many doctors have viewed it not as a disease but as a vice resistant to treatment in a medical context. But as this outmoded view fades, pressure is being put on medical schools to expand their curriculum in this area. While this is good news for employer sponsored plans, it will obviously take time for providers to be better trained on addiction treatment.

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In late May, Martin Senn, the former CEO of Zurich Insurance Group, took his own life just months after leaving the company. Only three years earlier, the company's former CFO, Pierre Wauthier, also committed suicide, and not long after that, so did Swisscom CEO Carsten Schloter.

 

 

 

 

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There has been much focus lately on the dramatic differences in the cost of services from hospital to hospital and market to market, and questions about the lack of price transparency abound. But even more concerning is the variation in quality. According to a May 2016 study by the National Center for Health Statistics, CDC mortality statistics don’t tell the whole story. If “preventable medical errors” were on the list of the leading causes of death in the United States, they would rank 3rd, claiming more lives than diabetes, strokes, and respiratory disease each year. To add to this, we know that the patient experience is sub-optimal at best and, in healthcare, we know there is no known relationship between cost and quality. All of this makes a strong case for Centers of Excellences, or COEs.

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The move from fee for service to payment for value is real. This blog post on the Health Affairs site provides a glimpse into the progress being made with this new approach to contracting with providers. I was struck by one sentence in particular – Patients are the most underutilized resource to help reach positive medical outcomes. Since 155 million Americans are covered by employer-sponsored health plans, employers are in a unique position to be able to influence patient behavior. With the advent of consumer-directed health plans, health advocacy and other well-being programs, we have made strides in promoting consumerism and empowering patients. While we have a long way to go to get plan members more comfortable and confident in this role, there’s a big potential upside.

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Last week, an employer I was speaking with on my favorite subject, value-based care, made the comment, “None of my carriers are charging me any ACO fees.” I didn’t want to be a wet blanket, but I had to point out that unfortunately this was most likely not the case. So how does it happen that an employer might not know about fees for value-based care? And what should they do about it?

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I recently sat down with Lenny Sanicola from WorldatWork to discuss what’s trending in employer-sponsored health plans. We discussed telemedicine, consumer directed health plans, centers of excellence and more. Listen in to learn more about the future trends and drivers identified by Mercer’s national survey.

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