Health Insurance (CONT’D FROM PAGE 18)
cost to see a provider or undergo a procedure,” said Kelly. “We’re not getting that right now, and that’s a problem.” Market observers are also looking for clues as to wheth- er Washington will extend Biden administration tax subsi- dies for health coverage passed in The American Rescue Plan Act (ARPA) and extended in the Inflation Reduction Act. Such subsidies have been giving financial incentives for employers to encourage workers to get coverage through the marketplace provided by the Affordable Care Act. Watching The Till Comments from consultants suggest employers are looking for new health insurance models that will break through traditional barriers to care while capping costly fees. Some observers believe employers should go fur- ther: Start thinking about health care coverage less as tra- ditional insurance to cover unlikely events, and more as a
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separate stream of incoming invoices that will require fi- nancing—and would benefit from the same control as any business account. “Understand that everybody in the healthcare system makes more money when premiums rise,” said Donovan Ryckis, CEO of Ethos Benefits, a consultancy. “That in- cludes doctors, hospitals, pharmacies, and drug manufac- turers. To think they’re going to manage things prudently and responsibly. . . it’s just not going to happen. Once we understand that, we can take steps to lower costs by find- ing more responsible vendors to price things more appro- priately.” Tracking prices and negotiating for better ones requires expertise, and it behooves employers to work with service providers who understand the complexities of physician networks, coverage and benefits categories, prescription drug coverages, and cost management. “The right advisor can act as an employer advocate with the markets,” said Barton. “The result can be a favorable outcome in terms of program construction, cost and performance.” The best advisors share several characteristics, noted Barton. The first is knowledge of the market. The second
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