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State Regulations & Controlling Healthcare Costs

A Discussion with Self-Funding Expert Brooks Goodison & ShiftShapers David Saltzman

Brooks Goodison, President of Diversified Group, takes part in the ShiftShapers podcast with David Saltzman, Chief Transformation Strategist. In Part 1, Brooks helps sort through the changes underway that target employer groups that want to move away from fully-insured plans. In Part 2, he highlights strategies that employer groups are using to fight the rising costs of healthcare as a result of the ACA.

Part 1: States Regulation of Stop Loss Narrows Markets

Self Insured Plans have proven over and over that they provide excellent benefits. They are not skimpy or skinny or cut-down plans. Employers are using self insured plans to offer excellent coverage - as good or even better than what is regulated by the states, in most cases. And they are doing well and are able to provide those benefits cost-effectively. – Brooks Goodison

A quiet battle at the state level may make it more difficult for you to be creative in the small and mid-market spaces. New York, Maryland, Connecticut and other state regulators are changing stop-loss insurance regulations in ways that would severely impact the number of employers able to take advantage of partial self-insured options.

Employers looking for strategies to move the needle on healthcare costs will find this discussion valuable. Watch Part 1 Video to Learn More.

Part 2: Controlling Healthcare Costs in an Election Year

Employers should understand that there’s an impact they can have. Let’s try to get deductibles back down into a reasonable area and get these premiums away from comparable to a mortgage payment and bring them down to say, a car payment. Reference Based Pricing has made this happen for many employer groups. – Brooks Goodison

In this ShiftShapers podcast, Brooks highlights strategies that employer groups are using to fight the rising cost of healthcare as a result of the ACA. Healthcare expenses can easily become one of the largest expenses for families and the rising costs have a direct impact on a consumer’s ability to plan for their financial future.

Given this reality, employers are actively looking for ways to control healthcare costs. Brooks identifies the pros and cons of reference based pricing and provides case studies on how these programs compare to traditional PPO contacts.

Watch full video for insight from Self-Funding and Reference Based Pricing expert, Brooks Goodison.


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