Have group health plans outrun their logistical limits?


By:          Zack Pace, SVP, Benefits Consulting

This week, I had the privilege of attending NCQA’s 2016 Quality Talks. CBIZ was a proud sponsor of this year’s event, which featured the best and brightest minds in healthcare outlining their vision of healthcare’s future. The “TED”-style talks were visionary, inspiring, and actionable. I’m excited about converting many of the ideas shared into techniques employers can use to both improve its employees’ healthcare experience and to lower plan costs.

For example, the final speaker, Reed V. Tuckson, MD, FACP, articulated the efficiency challenges telehealth is solving and shared how this technology will further revolutionize healthcare in the years to come. The examples he shared extend far beyond an individual simply video-conferencing with a physician.

However, the trouble in incorporating many of these exciting ideas into employer sponsored health plans is that we seem to have outrun our logistical limits. It reminds of Batu’s 1241 military campaign across the Hungarian plains. Do you remember that history lesson? In 1236, Genghis Khan’s grandson, Batu, led the Mongolian army on a westward campaign. The army encountered little resistance as it swept across the vast Eurasian steppes and into Eastern Europe. But, as he came across the Hungarian plain, Batu’s horse archer cavalry encountered a new kind of resistance – fortified masonry castles.1

Perhaps, nowadays, the rapid advancement of healthcare technology and innovation is like a benevolent, lightening western campaign and ERISA, the Affordable Care Act (ACA), and existing IT limitations are the fortified masonry castles (no, I’m not arguing that Batu was benevolent).

Coincidentally, my latest essay for Employee Benefit News, Why employers need to verify compliance with new benefits, shared a story of our recent encounter with one of these fortified masonry castles. In short, an employer seeking to leverage telehealth technology to improve its employees’ mental health almost ran right into the massive ACA 4980D penalties, and, further, almost disqualified its employees’ Health Savings Accounts. Luckily, we called off the advancement just short of these fortified castles.

Here’s the full article – Why employers need to verify compliance with new benefits. You may need to register with Employee Benefit News to view it.

You can reach me on zpace@cbiz.com or via Twitter. My collection of LinkedIn essays is located here, and my Employee Benefit News articles are available here.

  1. If you’re interested in studying Batu’s western campaign, an excellent source is the audio course The Barbarian Empires of the Steppes via the Great Courses. Professor Kenneth W. Harl, Ph.D. is superb.
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Zack Pace

Zack Pace, SVP, Benefits Consulting at CBIZ Inc., and his team design, implement, and manage benefits packages that are highly effective at empowering clients to attract and retain the top talent needed in order to outperform competitors, while ensuring that the cost of the overall benefits program and its components are cost-effective.
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