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Continuing the Conversation
On 2/15/23 we had
Donovan Pyle, CEO, Health Compass Consulting
How Do You Know If Your Health Benefits Are Any Good?
A Certification to Validate Vendor Claims
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Donovan put the task of reform on his fellow "rosetta '' agents, since no one in the cartel will reform themselves.The problem, though, is employer skepticism about any health plan outside of the insurance companies. Advisors, then, must offer "baby steps'' to CFOs, stemming from saving money around expenses one can control: facilities, imaging, labs & drugs.
With all the medical errors, advisors need to help employees choose wisely. CEOs need advisors who can vet vendors, who should NOT be paying the advisor (let alone disclosing such payments). Business owners should pay a flat fee to advisors, to ensure the latter perform objectively. Advisors can rely on Validation Institute vetting of vendors, and even get certified from VI in advising. With or without validation, at some point advisors are going to face ERISA fiduciary enforcement from the Labor Dept, for conflicts of interest between their carriers and their customer business owners.
25% of health spending is wasteful, and contracting directly with quality providers can stem unjustified utilization. The big tsunami coming are specialty drugs - which account for 75% of new drugs. Only 15% of them are efficacious, though. Another study, from Oxford, found only 6% of drugs with backing from evidence determined to be "high quality". Ron Bailey at Reason famously found equally small percentages for trials that are reproduced - demonstrating the same result when repeated. Drugs don't work, but rip off payers. We've got to get workers off drugs!