Under the COVID-19 vaccine distribution plan, each jurisdiction - state, county and some municipal health department- decides the prioritization of who gets the COVID-19 vaccines, as well as who is contracted to provide vaccines to providers in their jurisdiction. Employer members want to identify, contact or directly contract with the jurisdiction responsible for your area. This may be helpful for multi-state employers. Houston’s Immunization’s Manager is Omar Salgado with the Houston Health Department, [email protected]. For others and to learn more, COIVD Immunization Managers. In addition, the National Governors Association have released a resource providing information on State Approaches to the Phased Allocation of Vaccines
Houston employers are concerned about providing chronic disease prevention to their covered lives during COVID as most in-person wellness programming is at a standstill. This concern will remain as most employers are transitioning to variant forms of permanent remote work. Fortunately there is a Houston solution to decrease the frequency of progression of prediabetes to Type 2 Diabetes, and obesity. The University of Texas Medical Branch (UTMB), The University of Texas Health Science Center at Houston (UTHealth), and HBCH have partnered together to VIRTUALLY offer the National Diabetes Prevention Program (DPP) to Houston employers. Attributes include price, pay for performance, LIVE ONLINE Coaching & Peer Support, flexibility of cohorts, nights and weekend delivery options, and more. READ MORE
As of January 1, 2021, the United States Department of Health and Human Services requires that hospitals publish payer-negotiated rates for common services on their websites. A second set of rules, which requires insurers to provide rate and cost-sharing estimates for common services, is scheduled to go into effect in 2023. (85 FR 72158). While the new rules are intended to help patients save money by choosing lower-priced care, the analysis finds that many employers and patients still will still face significant barriers to shopping for common health services. Ongoing litigation challenging the constitutionality of the Affordable Care Act (ACA) and the price transparency rule aimed at hospitals could affect the implementation and impact of these new rules. President Biden expressed support for greater healthcare price transparency during the campaign, but has not commented specifically on the Trump Administration regulations. The Kaiser Family Foundation recently released a brief on its potential impact. The KFF Brief summarizes the key requirements for hospitals, insurers, and self-funded employer plans under the new price transparency rules. Health plans will be required to provide by January 2022 the 1) negotiated rates for all covered items and services between the plan and in-networks providers; 2) historical payments and billed charges from out-of-network providers; 3) in-network negotiated rates and historical net prices for all covered prescription drugs at the pharmacy location level.
A peer coalition of HBCH, the Pacific Business Group on Health recently hosted a conversation with Don Berwick, MD, former CMS Administrator under the Obama administration. Dr. Berwick shared insights into a reimagined health care system that purchaser want and are proud to pay for, as well as suggestions on how purchasers can address social determinants of health. The conversation concluded with a collective call to action informed by both purchaser and provider perspectives. In the words of Dr. Berwick, “I’ve lost patience with marginal change” . Time will tell if purchasers feel the same. Don Berwick PBGH Video
REGISTER for the February 17, 8:30-10:30 webinar on Hospital Price, Quality, Finance Transparency. This may be the most important program ever hosted by HBCH and is Free to all healthcare stakeholders! Attendees will learn the results of the most recent RAND Hospital Price Transparency Project which in aggregate show employers in Texas pay 250% of Medicare pricing; the results of the National Academy for State Health Policy’s Hospital Cost Tool for Houston Hospitals that suggests employers are paying much more than is needed to support the sustainability of high-quality healthcare in the Houston market; the link between hospital pricing, quality and outcomes; and the implications of CMS’ new Hospital Price Transparency Regulation.
“Employers will see tremendous value in this session as healthcare thought national thought leaders Chris Whaley, Marilyn Bartlett and Shane Wolverton shine some light on a dark corner that impacts all companies and employees, the varying cost and quality of care delivered in hospitals. Achieving true value in healthcare will require good-faith collaboration between employers, payers and providers to ensure the ongoing viability of our system.” Dan Burke, Benefits Director, Turner Industries and HBCH 2021 Board Chair.
Speakers will be national thought leaders Chris Whaley, PhD, Principal Investigator for the RAND Project; Marilyn Barlett, National Academy for State Health Policy and developer of the Hospital Cost Tool; and Shane Wolverton, Sr. VP with Quantros Health, a national provider of hospital and physician quality outcomes. We will also have a panel discussion with key stakeholders – employer, consultant, health plan, hospital.
We are optimistic that these never before resources available to all will stimulate discussion and action to derive a better model for delivering high quality healthcare at prices that are now negatively impacting the health and well-being of employees, their dependents, and the future of the Texas workforce. Or as stated by an HBCH Board member and supported by all, “Our employees and our businesses are being crippled by healthcare”