POLICY/THE INDUSTRY/HEALTH PLANS: Employers trying to be not so dumb

This is definitely one to watch. With help from THCB buddy Brian Klepper, the employers in Reno are interested in becoming smarter purchasers, and they held a forum without letting any plans or providers in the room. The results suggest that they’re pretty serious about pooling their data instituting P4P & transparency, and basically doing what their health plans should but don’t do. The employers account for about 25% of the population in northern Nevada.

All employer groups have had this clout potentially. None of them have ever used it. And usually they’ve been too chummy with the delivery system or have been bamboozeld by their “agents” the health plans and PBMs. It’s possible that in some places the worm is turning.

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Brian KlepperBarry Carol Recent comment authors
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Brian Klepper

Good question and good point. I’ll find out.

Barry Carol
Barry Carol

How do they plan to get around the confidentiality agreements that prohibit disclosure of actual insurer reimbursement rates? Isn’t confidentiality a part of virtually all managed care contracts? It would be great if these provisions could be eliminated, by legislation if necessary.