For plan sponsors, managing healthcare today is a little like choosing dessert at a really good frozen yogurt shop: Too many choices can lead to analysis paralysis, beguiling the most seasoned benefit professionals.
Clarity comes from cherry picking the best care delivery and payment vehicles. Cherry picking in the business world originates in Japan, where for decades corporate leaders have practiced dantotsu – or, “best of the best” – a form of benchmarking to identify and adopt best practices. Groups of business leaders from Japan have ventured to North America and countries across Europe to visit companies and see what they do right, and how.
If self-funded employers were to practice dantotsu, they’d travel to Alaska, surprisingly. There, healthcare costs are rising faster than in any other state, more is spent on healthcare per person than anywhere but Massachusetts and access to orthopedic and other specialized care is difficult, with more than 70 percent of the state inaccessible by road.
In The Last Frontier, plan sponsors would find an organization that – against all odds – enables the best surgical care at the lowest cost for its employees. In 2013, Alaska Teamsters contracted with BridgeHealth for value-based surgery benefits. BridgeHealth negotiates with centers of excellence – the nation’s top-performing surgical teams, according to an independent third-party ranking – for episode-of-care case rates. BridgeHealth bundles the charges for each of the most common surgeries into a single discounted price.
Through BridgeHealth’s program, Alaska Teamsters spent nearly $1.3 million less on surgeries between 2013 and 2016 than it would have through its PPO health plan.
“These savings go straight into our investment fund, where the money grows to pay for the underlying claims of our self-funded health plan,” said administrator of Alaska Teamster-Employer Welfare and Pension Trust Plans. “And the quality of BridgeHealth’s national network is very high. Not a single surgery through BridgeHealth has led to a hospital readmission.”
The good news is dantotsu can uncover value-based surgery benefits and many other best practices. In The Last Frontier and across the country, the self-insured can discover the new frontier of better, lower-cost healthcare.