美世 - Consumer Driven Health Care Pricing and Design.ppt

Consumer Driven Health Care Pricing and DesignSession 51The Conference and Academy2004 Annual Meeting October 20, 2004 Economics Change “Nobody spends somebody else’s money as carefully as they spend their own.” - Milton Friedman “We always over estimate the change that will happen in two years and under estimate the change that will happen in ten.” - Bill Gates “Healthcare is a failed marketplace today because the person paying the bill isn’t the one choosing the service.” - Howard Wizig, Vivius “I am convinced that if the rate of change within an organization is less than the rate of change outside, the end of the company is in sight.”  - Jack Welch ConsumerismWhat is it? Employer Characteristics What employer characteristics make adoption of consumer strategies easier? Well-educated, self-sufficient employees Existing meaningful employee contribution to health care costs High overall employer health care cost Low union membership Corporate culture and support of independent employee choice Employee dissatisfaction with current options Good intranet infrastructure and high internet use among employees Self-funded health plan Large cost increases with existing plans (to create the incentive to move) CDHP Basic coverage for routine and preventive services Support services for people with chronic illnesses Accounts for discretionary medical spending (HRA/HSA) Coverage for catastrophic coverage Member cost sharing features CDHPOne Approach to Consumerist Design Consumer Directed Health PlansMulti-year Results-driven Program Design Account-Based Plans Accelerating CDHP Designs EvolvingAccount Amounts Incentives CDHP Designs Get More ComplexCost Sharing CDHP Designs Get More ComplexMultiple Designs Along Come Health Savings AccountsHRA or HSA: Decisions, Decisions… Mercer has worked with approaching 60 organizations to offer an account-based CDHPs effective 2004 and earlier All but one of these was HRA-based (1 HSA-based pro