On April 4th, HealthCare 21 Business Coalition brought together 100 healthcare stakeholders for an educational event at Nissan North America headquarters. The event featured an update on the State of Tennessee’s Insurance Exchange planning initiative, an overview of the State’s value based benefit design as well as information on ACO implementation in Middle Tennessee. Each presentation touched on how reform is changing the way that Tennesseans think about health care delivery and health care benefits.
Brian Haile, Director, Insurance Exchange Planning Initiative: Haile’s presentation began with an overview of changes brought about by the Accountable Care Act (ACA). Perhaps some of the most striking changes come from the individual insurance market. We’re likely to see an altered health care marketplace as new options enter Tennessee’s market, which may include a State Insurance Exchange. An Insurance Exchange is an organized marketplace where individuals can browse and buy health insurance for themselves and their dependents. Every state is required to have an Insurance Exchange under the federal health reform law. Tennessee has created an Insurance Exchange Planning Initiative to monitor the guidelines and standards released by the federal government related to Insurance Exchanges. The federal national health reform law requires all states be ready to implement their Exchanges by January 1, 2014. Haile emphasized that comments and questions regarding Insurance Exchange planning in Tennessee should be sent here. With the Supreme Court ruling pending and many anticipated changes on the horizon, Haile encouraged employers to consider how reform may impact their decision-making as they design benefit plans. (Presentation Not Available)
Laurie Lee, Executive Director – Benefits Administration, State of Tennessee: The State of Tennessee is designing a health benefit strategy to encourage better health management while also controlling health care costs. Beginning in 2011, State beneficiaries received a choice of two health benefit plan options. Both plans are PPOs, but the Partnership Promise rewards members for improving or maintaining good health through better cost sharing. A health risk assessment and biometrics are requirements of the Partnership Promise plan. In the first year, 80% of members chose the Partnership Plan. Key takeaways for employers include that communication is the key to success when implementing benefit design changes. Lee also encouraged employers to take the time to learn from innovators – such as other employers, coalitions, etc. – to design the most effective benefit offerings for their employees. (Presentation)
Jason Dinger, CEO, MissionPoint Health Partners: Accountable Care Organizations (ACO) are a development from the ACA. MissionPoint’s goal is to link together primary care physicians, specialists, pharmacy services, hospitals, rehabilitation services and wellness programs to offer patients and employers a seamless continuum of care. Prior to their launch, MissionPoint conducted hundreds of interviews with providers, caregivers and patients to determine what each stakeholder group wanted to receive from their health care. Findings ultimately shaped MissionPoint’s 4 aims focused on improving the patient experience, improving the health status of the community, including caregivers in the process and reducing health care costs. Dinger described how ACOs are charged with incenting providers in a new ways while also ensuring that patients have a primary care physician who actively coordinates care across the health care system. An innovative new technology referred to as the “patient pod” provides some patients with a remote connection to their doctor that “feels real” and has received high satisfaction from early users. (Presentation)
HC21 would like to extend a special thank you to our speakers, our host Nissan North America and our sponsor Novo Nordisk for a highly productive meeting.
If you have questions, please email Ashley Johnson, or phone (865) 292-2121.