If you weren’t able to attend the Texas Association of Health Plans (TAHP) 2021 conference in Austin, TX, have no fear! Our team was there and we put our heads together to identify the most important takeaways from this gathering of health plans. 

If you work in the health benefits industry, you better know the key topics on health plans’ radars so you are prepared for what’s coming next and can plan to proactively respond. The TAHP 2021 takeaways in this blog give you direct insights into what’s important right now to health plans! Check them out below:‍

Takeaway One: Price transparency, disparity, and increases.‍

Price transparency and all the regulations that are coming out around transparency are a hot topic for everyone in healthcare. Transparency in healthcare prices, disparities in healthcare prices, and increases in healthcare prices were all big topics at TAHP. One session that we thought covered this conversation particularly well was “​​Health Care Prices and Consolidation are Out of Control: Where Do We Go From Here?” featuring Loren Adler, Niall Brennan, and Robert Town.

In it, the panelists identified four main reasons why private insurance rates are so high:

• Limited competition.
• High consumer value on choice of provider.
• Public policies that limit insurer leverage.
• Greater public sympathy for providers than insurers.‍

Why it Matters: These high prices lead to a financial burden on consumers (households & government), inefficient care delivery, limited access to care, and low-quality care. While some may say this has to do with increased utilization, HCCI data showed that healthcare spending has, without a doubt, increased due to service prices going up, not because of higher utilization or an increase in quality of care. (See the chart below)

‍Takeaway Two: Hospital consolidation is leading to higher prices.‍

Not exactly a shocking revelation, but it is a huge factor that creates higher healthcare costs and is continuing to happen. As Chris Skisak, Executive Director of the Houston Business Coalition on Health explained:

• There’s little to no correlation between prices and costs. Hospital prices are largely based on what the market will bear. In Houston, as an example, they are seeing prices that are 200-600% of what Medicare costs.

Robert Town, a healthcare economist at the University of Texas shared research showing integration leads to 8-13% higher prices.

‍Why it Matters: Hospital consolidation is not going away and as we see this trend continue it will inevitably mean higher prices and overall costs for health plans.‍

Takeaway Three: Concerns about new health coverage models like ICHRAs.‍

If you’re unfamiliar with an ICHRA, it stands for Individual Coverage Health Reimbursement Arrangement and is explained well in this slide from Jack Cooper, CEO of Take Command Health:

ICHRAs shift purchasing power from aggregated employer groups to individual employers so there is concern that health plans may disrupt the current employer based model. Plans could lose business through ICHRAs since they operate by allowing members to choose whatever health plan they want based on how much their employer will reimburse. 

The benefit of ICHRAs is that employers who don’t want to be involved in healthcare get to greatly remove themselves from it. Also, 80% of the groups participating in ICHRAs are giving benefits for the first time ever. So up until now, they hadn’t been able to offer health coverage because of cost, but ICHRAs have made it possible for them to offer some form of health coverage to employees. That obviously is also a huge benefit to employers and employees. ‍

Why it Matters: New models like ICHRAs are changing how employers provide health insurance to their employees which creates new opportunities but may also mean shifts in the traditional employer model.‍

Takeaway Four: Consumer experience and empowerment.‍

The TAHP Conference also saw several panels discussing how to improve the consumer experience, how to empower people to be better healthcare consumers, and the situations that are negatively affecting the consumer experience. One of our favorite panels, “Unpacking The No Surprises Act: An Opportunity To Protect Millions of Texans” featured Loren Adler, Patricia Kelmer, Laura Klempay, and Pati McCandless. The panelists discussed how this landmark legislation will be implemented and what Texas can learn from the new law and rules. Some of the best takeaways can actually be found in this Twitter thread from our Director of Marketing, Steven Cutbirth.

Dr. Marty Makary also discussed the consumer experience and empowerment in the opening presentation for TAHP. He gave a great talk on price transparency and the companies (like us) working to make price transparency data useful for patients. He also discussed high healthcare costs and appropriateness of care. Our Chief Growth Officer, Doug Bain, captured a great paraphrase from the talk in this tweet:‍

Why it Matters: Consumers are fed up with the current state of health insurance and that includes the terrible experience they are put through. It’s far past time to make calling your health insurer a bearable experience. If the current players can’t do it, new entrants will and patients will flock their way.

‍Final thoughts.‍

Now that you know what's trending in the health plan world, it’s time to take action. If you don’t start addressing these topics proactively then you will miss the opportunity to implement creative solutions and stand out from the traditional players.

These issues are the exact things we are working on solving at PointHealthTech and we’d love to chat with you about your plans to address them. Just reach out to us here: www.pointhealthtech.com/request-a-demo