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Politics

Health Care 'Shared Savings' off to a Slow Start

June 18, 2019 - 7:00am

If people are willing to shop for cars and homes to save money, they’d be willing to shop around for their health care, right?

If early results of “shared savings” programs in Florida’s state-employee health insurance program are any indication, the answer actually could be no.

The early results show that despite efforts to publicize the programs, they have had little impact on the $2.6 billion health-care program for current and former state employees.

The idea of the shared-savings programs is to give policyholders an incentive to look for cheaper health services. State employees receive rewards after the services have been delivered and claims paid.

As of May 21, $63,000 in rewards had been earned by employees who enrolled in what is known as the Healthcare Bluebook program, according to the Florida Department of Management Services, which oversees the employee health insurance.

David Frady, the department’s communications director, did not have the number of employees who used the program but said 428 different services, such as X-rays and MRIs, were booked and paid for.

State employees who want to shop around for surgical care can use a program called SurgeryPlus. The latest available data show that six procedures have been completed through the program and that another three have been scheduled. Files have been opened, Frady said, on another 46 potential surgical procedures.

The less-than-robust performance has occurred despite the Department of Management Services’ efforts to advertise the options. Gov. Ron DeSantis in March ordered the agency to “get as many people plugged into that as possible.”

Frady said the department has been working closely with agency human-resource directors to distribute educational materials to employees on the availability of the programs. The department has also included information about Healthcare Bluebook on its People First website, which is the portal for state employee benefits.

Since March, the department has held 49 in-person presentations, and webinars have been offered “reaching thousands of employees.”  

Meanwhile, the state has paid companies involved in the programs far more than what employees have been able to attain in rewards.

Healthcare Bluebook has been paid $1 million since October 2018, according to a state financial website. The contract is worth a total of $3.6 million. Direct Employer Healthcare, which operates as SurgeryPlus, has been paid more than $462,500 for the concierge-type services that help people shop for and procure surgical services. The overall contract with Direct Employer Healthcare is for $4.2 million.

DeSantis has touted shared-savings programs similar to the ones in the state-employee insurance plan as an attractive option to help lower overall health-care costs. Along with House Speaker Jose Oliva, R-Miami Lakes, DeSantis supported a bill (HB 1113), which seeks to spur insurance companies to begin offering similar options to customers.

DeSantis signed the legislation into law last week. The law, which takes effect July 1, allows insurers to offer shared savings options to their customers. Insurers would have to return at least 25 percent of any generated savings to the customers.

Enrollment in the programs would remain voluntary.

DeSantis expressed confidence that consumers will take advantage of the offerings because they’d be getting back a portion of the savings.

“The transparency is great, but why would I want to go shop online if it makes no difference to me as a consumer?” DeSantis said during an appearance last week in Jacksonville. “If it’s just saving an insurance company money, I think a lot of patients would rather just have their time to themselves rather than doing this.”

Comments

With the exception of Nixon creating the Environmental Protection Agency, Republicans haven't created ANY programs or policies that have truly benefited the general public since the administration of Theodore Roosevelt. And, given their recent history versus the Affordable Care Act and the expansion of Medicaid ... they're certainly incapable of coming up with real improvements to healthcare insurance programs.

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