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A Clear Path To Lower Healthcare Costs
1. CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE
CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE
A Clear Path To Lower
Healthcare Costs.
2. CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE
CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE
Meet
Christian
Insurance Pays
Hospital Charge
Discount
Christian’s OOP
..…. $3K
… $68K
…………. $34K
.… $31K
Insurance Pays
ASC Charge
Discount
Christian’s OOP
..…. $3K
……….. $8K
….…………. $0
…... $5K
Why Does Transparency Matter?
3. CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE
81 Million
126%
+
52%
+
2010 2021 2009 2021
Healthcare cost
are going up
Insurance deductibles
are going up
$3,000
>
Americans have
a deductible of
$5,000
>
4. CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE
But Why?
Health Plans
(For-Profit, MLR)
Providers
(For-Profit)
Employers
(Don’t Understand)
Employees/
Patients
(Don’t Have Tools)
5. CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE
Price Transparency
Mandate
2019 2021
Price Transparency Timeline
January 1, 2022
Machine readable file
must be posted on
health plan website.
Price Transparency
Support
January 1, 2023
Online self-service
tool for 500 specified
services must be
provided by health
plan.
January 1, 2024
Online self-service
tool for all items and
services must be
provided by health
plan.
2022 2023 2024
6. CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE
Economics 101
The Profit
Motive
Minimal Government
Intervention
Competition Lower Prices
=
7. CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE
Healthcare Economics FAIL
The Profit
Motive
Minimal Government
Intervention
Competition Lower Prices
=
8. CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE
Everything but Healthcare Healthcare
In Healthcare, Cost Does Not Equal Quality
Higher Cost Higher Quality Higher Cost Lower Quality
=
=
9. CONFIDENTIAL | DO NOT COPY OR DISTRIBUTE
We either figure out how to fix high costs or the government will step in.
Fix it or Forget It