In previous posts, we have focused our criticism on payors as rogue warriors in search of ever higher margins thru the impact of decreasing costs (taking advantage of their size by making providers take it on the chin) and increasing premiums to employers (and the employees thru higher co-pays) which have resulted in some nice stock options and buying sprees in their ever increasing consolidation of about 4–5 real players in the insurance industry.

This occurs of course because they have no vested interest in aligning their policy with quality and because they forget about the sustainability of their customers (employers).  I suggest they take notice of a new survey from the National Group on Health/Watson Wyatt Consulting.

Here are some relevant findings:

-about 38% of companies now offer consumer-directed health plans (CDHPs), up from 33%

-cost sharing (e.g. higher co-pays) has not resulted in better results (savings)

Before I go on, let’s apply this to the PT world.  We are now seeing plans that some payors have implemented whereby the patient has upwards of a $50 co-pay.  Does it result in less visits in PT-you bet. Does it result in the long-term best interest of the patient-doubtful.  Does it result in impaired progress and overall dissatisfaction with the health plan-I am sure that it does.

The survey found that the best performing companies are more likely to offer meaningful financial incentives for employee education and participation than the poorer performers.

They found that quality and providing information on the best “procedure-specific” centers coupled with financial incentives (meaning less co-pay) resulted in improved performance and savings.  If you want to save money in health care, drive your patients to the best providers thru information and then incent them to use those providers thru lower co-pays.

Sounds so simple.

Larry