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The Year in Healthcare: A Focus on Cost Management

18 04 EB The year in healthcare A focus on cost management - The Year in Healthcare: A Focus on Cost Management

It appears that cost management is of increasing importance to employers, with employers being willing to experiment with new ways of stemming expenses. There has been a growth of group captives in recent years, whereby employers keep their self-funded plans with group stop-loss insurance. This stems the risk and allows the self-funding of smaller groups.

Although the interest in self-insured captive insurance has grown, there remains to be confusion surrounding the arrangements. The president and founder of Roundstone LLC, Mike Schroeder, outlined 5 common misconceptions in an EBA article recently. Among the misconceptions, it is commonly believed that these captives result in higher costs than fully insured renewals; self-funding them is too complex; and that some businesses are too small to see any real benefits to them.

Mick Rodgers, EBA’s 2017 Adviser of the Year, also reshaped health insurance for his firm, which has a dozen employees serving 256 employers group with 16,530 lives. Rodgers then made 4 healthcare purchasing coalitions, consisting of more than 11,000 members from 64 middle-market employers. The employers had headcounts from 100 to 500 employees, hailing from 35 different states. At a mere $7,065 PEPY as of 2016, their health benefits were 41% less than the US average of $11,990 PEPY.
Healthcare reform efforts go on

Healthcare reform shows no signs of slowing down, with a constant “will they won’t they” situation seeming to surround healthcare reform all through 2017. The Senate didn’t pass GOP legislation, though the industry is still searching for an alternative to the Affordable Care Act’s requirements regarding reporting.

President Trump’s tax reform bill includes a repeal of the individual mandate. This has made employers rather worried if healthy employees decide not to purchase health coverage, as the employers may see potentially adverse selections. The individual mandate’s repeal has worried many business groups, with business groups worrying that it may cause the health insurance marketplace to become volatile and unstable. It may also move costs towards stable health insurance customers and employers too.

Trump signed an executive order in October which ordered federal agencies to take certain actions as a result of federal rule-making. Association health plans could potentially be created by small employers grouping together, allowing them to buy insurance together, rather than via Obamacare. Trump’s executive order also encourages the expansion of low-cost, short-term, limited insurance plans, in addition to using tax-advantaged accounts to pay off healthcare-related expenses.

Employer groups continued to call for the repeal of supposedly harmful ACA taxes throughout 2017. The US Chamber of Commerce and the ERISA Industry Committee wish to see the repeal of the Cadillac tax and the Health Insurance Tax, as these are two notoriously disliked provisions of the Affordable Care Act.

As governments change and power is constantly shifted back and forth in the White House, healthcare plans can inevitably hang in the balance. If you wish to remain abreast of the latest situations (and get great advice) then get in touch with us!