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Opinion
One Man’s Opinion: Route to Lower Health Care Prices Still Mapped by Private Sector
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One Man’s Opinion: Route to Lower Health Care Prices Still Mapped by Private Sector

One Man’s Opinion: Route to Lower Health Care Prices Still Mapped by Private Sector

One Man’s Opinion: Route to Lower Health Care Prices Still Mapped by Private Sector

No longer able to rely on traditional cost sharing techniques to manage costs, a growing number of employers are taking an activist role in shaking up how care is delivered and paid for," said Brain Marcotte, CEO of the National Business Group on Health, as reported by CNN.

Healthcare remains the only major economic sector and consumer of roughly 20 percent of the GDP, where the customer generally has no idea on costs, particularly on an insured procedure, medical appointment or prescription drug until AFTER they place the order or receive the service. 

Many employers, large and small, who want healthy employees and want to provide benefits have found the current service and funding model to be irreparably broken, and an increasing number of larger companies are employing direct service plans, ranging from onsite medical clinics to incentivizing wellness and Health Saving Account options (HSA), which are particularly popular among younger/healthier employees. 

In an odd twist of irony, well over 24,000 GM salaried employees across southeast Michigan will next year be able to select such a less expensive service delivery model (with significantly lower premiums) with care provided exclusively by the Henry Ford Healthcare System. Ford Healthcare will provide all medical services, surgeries, and E.R. visits, as well as prescription and pharmaceutical products via its network of six hospitals, 3000 doctors and health care providers through GM's new "Connected Care" plan. GM's thousands of hourly workers and Union employees will continue to receive health care via a contracted benefits plan and more traditional service model. Connected Care will also provide wellness exams, chronic care monitoring and preventative screenings, in addition to prompt appointments with providers and virtual visit options delivered via telemedicine. 

Comcast, the nation's largest cable provider and owner of NBC networks as well as Universal Parks & Resorts, is turning its $169-billion behemoth ship as well as holding the annual increase in its health care costs to roughly 1 percent a year. Comcast spends roughly $1.3 billion a year on health care for its 225,000 employees and their families. But instead of charging their employees higher premiums, Comcast has instead selected a flat up front deductible expense (subtracted from payroll) of on average $250.00 per employee. That is an ANNUAL figure. 

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Healthcare Bill Crane

Instead of handing this massive headcount to any leading insurer, Comcast is directly contracting with a handful of highly specialized service providers. Comcast uses several technology start-ups, one of them called Accolade (in which Comcast is also an investor) providing employees with health care Navigators to help them understand, as well as guide them through the host of service and treatment options. The focus is on keeping the employee healthy, without requiring them to become expert at managing co-pays, deductibles, generic drug costs or nearly requiring a medical certification or training if a member of their family is chronically ill. 

Another Comcast system provider, Grand Rounds, is available for more complicated health care challenges, serving as both a check on costs and charges, and a referral network of skilled practitioners for more complex surgical and related treatment needs. Insurers hardly love this delivery model, which treats them like an expensive middle-man, providing little or no real value or return on investment. 

Some insurers are receiving that message and also responding in the marketplace. Following a raft of research which demonstrates that health care costs decline when a consumer’s basic social and well-being needs are met, WellCare Health Plans of Tampa, Florida opened a call center for customers needing assistance with housing, transportation and other social concerns...now being connected to community and social service organizations, in addition to health care providers. 

Kaiser Permanente in Oakland, California, is investing $200-million in projects to protect and preserve affordable housing in the Bay area, to revitalize challenged neighborhoods as well as improve overall community health. United Health Care has partnered with another start-up called Healthify to use software in pre-screening new insured clients to better assist them with identifying social service and community support groups in addition to better coordinated care among their network of service providers to help insure better patient outcomes. 

Our traditional health insurance/government hybrid service delivery model has long been in need of a check-up and some surgical upgrades. Unfortunately our state and federal government leadership typically lacks the courage or stomach for touching this proverbial 'third rail' of American politics...leaving the private sector once again to try and shine a light and lead the way. More power, and more innovation to them.

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  • Channel 2 Action News is investigating a string of bomb threats that have been made across metro Atlanta and across the country.  Several metro counties and cities have reported threats. They coincide with threats that have been made across the country towards schools, city/county offices, businesses, newspapers and television stations.  LIVE coverage of this developing story starting on Channel 2 Action News at 4 p.m. Earlier in the day, five DeKalb County schools were placed on lockdown after police said someone called in threats to them. Here is a minute-by-minute look at what is going on: 3:33 p.m. Peachtree City police are investigating an email bomb threat to an employee at TDK on TDK Blvd. The department said it does not appear credible. 3:15 p.m. Cobb County confirms the courthouse was cleared and has resumed normal operations.  3:05 p.m. Calhoun EMA says the city has received multiple threats:  'We have received multiple bomb threats all over town. No dangers have been found at this time. Be aware of your surroundings but please stay calm. We have found nothing to validate any of these threats.'  3:02 p.m. The FBI has released a statement saying: “We are aware of the recent bomb threats made in cities around the country, and we remain in touch with our law enforcement partners to provide assistance. As always, we encourage the public to remain vigilant and to promptly report suspicious activities which could represent a threat to public safety.”  3:01 p.m. In Cobb County, authorities tell Channel 2 that threats have caused them to evacuate the courthouse. Threats were also made at Cobb County police headquarters, which also houses their 911 center, and police precincts 1 and 4.  @wsbtv @cobbcountygovt nobody is allowed in the building there are police at every corner and I was told by another another attorney that the judges were taken to a secure chamber— J. Feathers (@Evlfthrs) December 13, 2018 2:50 p.m. There have been at least four locations across downtown Atlanta where bomb threats have been reported.  Cartersville police said they are looking into a threat on South Erwin Street. Across the country: Bomb threats have also been made to universities, newspapers and television stations across the country.  We're working a number of bomb threat calls in OKC. There have been similar threats called into several locations around the country. No credible threat found at this point. We encourage the public to continue to be vigilant and call with anything suspicious.— Oklahoma City Police (@OKCPD) December 13, 2018 MSP Fusion Center tracking multiple bomb threats emailed to numerous businesses in the state. MSP Bomb Squad notified and local departments are responding in their communities. Similar threats have been received in other states. We will share more info when available.— Mass State Police (@MassStatePolice) December 13, 2018 CapAlert: There has been a bomb threat at Yochum Hall. Please evacuate Yochum Hall until further notice.— Capital University (@Capital_U) December 13, 2018 #BREAKING UPDATE: Second bomb threat made against library in Georgetown. Follow developments: https://t.co/WGlll81vWf — WPDE ABC15 (@wpdeabc15) December 13, 2018 #BREAKING UPDATE: Second bomb threat made against library in Georgetown. Follow developments: https://t.co/WGlll81vWf — WPDE ABC15 (@wpdeabc15) December 13, 2018 CMPD is actively investigating multiple unsubstantiated bomb threats in the Charlotte area. At this time, there are similar reports happening in other cities across the country. We’ll continue to release information as it becomes available. pic.twitter.com/eC9nMbxcGa — CMPD News (@CMPD) December 13, 2018 SCAM ALERT: There is a rampant hoax email being distributed across the country of a bomb threat making demands for money. Emails began locally around 1 pm. We do NOT believe these emails have any validity and direct you to delete email. Do NOT send money. More info coming soon— Grand Rapids Police (@GrandRapidsPD) December 13, 2018 (1/2) At approximately 10AM this morning #SFPD responded to reports of bomb threats at numerous locations throughout the city. SFPD is responding to each location. We have received information that several other cities across the United States have received similar threats. pic.twitter.com/AEyFanZRvr — San Francisco Police (@SFPD) December 13, 2018 Bomb threat messages via email have been sent to several businesses demanding ransom. No credibility to any individual threat generic email sent en masse— EL PASO POLICE DEPT (@EPPOLICE) December 13, 2018 We are currently monitoring multiple bomb threats that have been sent electronically to various locations throughout the city. These threats are also being reported to other locations nationwide & are NOT considered credible at this time. pic.twitter.com/GowGG4oZ9l — NYPDCounterterrorism (@NYPDCT) December 13, 2018
  • A 27-year-old man has died after falling while working as a window washer at the Trump International Hotel in Las Vegas. >> Read more trending news  Jonathan Garcia, of Las Vegas, fell to his death around 12:30 p.m. Wednesday, according to the Clark County coroner. Garcia's cause of death is pending. Witnesses said winds had pushed the rigging against the building several times before the man fell, reported KTNV-TV. Officials with the Trump organization released the following statement Wednesday: 'We are deeply saddened to learn of the incident today. We are working diligently with the owner of the third party company to investigate the details. Our thoughts and prayers are with the victim and his family.' The Nevada Occupational Safety and Health Administration is investigating the incident.
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