Health 3.0: The Next Online Generation Conference in Orlando Florida.
Here is the outline for this session from the published Agenda:
Health Care Reform: Perspectives on 2011 and Beyond
This panel will take a hard look at the impact of Health Care Reform on health plans. With the economy changing and new regulations beginning to be implemented, numerous questions arise as to whether or not this legislation presents a positive opportunity for health plans to capitalize on. Join three industry leaders as they assess how to leverage reform and open innovation as a catalyst for redesign and to find partners in the progress.
Director of Health Policy
BLUE CROSS BLUE SHIELD OF FLORIDA
Andy R. Anderson, JD
MORGAN, LEWIS & BOCKIUS LLP
What is going on in Health Care?
Texas and Florida are the only 2 states that have declared no intention to establish a state based exchange.
Q: when will we see more guidelines around how Exchanges will work?
A: (AA) 2012-13 before we see guidance. Carriers are thinking about what is going on. Some positioning is already starting.
(DP) What will Feds accept between now and 2012.
When State legislatures only meet for set periods (MD, WI etc.) there is a limited window to prepare state legislation.
(AA) Big employers are frustrated by State By State legislation. It would simplify managing national workforces.
Grandfathering – NAIC think this is ripe for abuse. New policies will be purchased and claimed to be grandfathered.
Q: Will we see Private Exchanges that competes against the State Exchanges? (PA expected to have a weak exchange)
A: (DP) Private exchanges don’t qualify for fed subsidies to be used to purchase insurance. It can only be applied to policies purchased through the state approved exchange.
Q: What will happen in the enforcement area?
A: (AA) 2014 penalties only $95. But IRS has not been given funds to enforce.
(DP) Average cost of uncompensated care across US is $1,700. The maximum penalty (2% of income) is significantly less than the typical cost of a health policy for a family.
Q: Rate Increase Reviews
(DP) Increased scrutiny at state level in 2011. High Deductible plans and HSA’s have increased cost awareness amongst consumers. This has discouraged people going to their doctor. This is leading to a spurt in big profits from High deductible plans.
(AA) HSA and High Deductible Health Plans (HDHP) are starting to work. The reform changes may strangle these policies.
Q: Healthy Rewards
(AA) Wellness programs – how do employers negotiate compliance with Federal laws such as American Disabilities Act. Rewards aren’t big enough to drive behavior.
Q: Accountable Care Organizations – How will they evolve?
A: (DP) it is difficult to work out what an ACO is. Rubber hits the road when money starts being distributed and being managed.
(AA) Everyone wants to be an ACO but no one knows what one is.