Last week, TLD Group Speakers Bureau faculty Dr. Kent Bottles presented the "The ACA Without the Individual Mandate." We share the webinar below. With so much to cover, Dr. Bottles has graciously agreed to provide answers to some of the most frequently asked questions below:
Q 1: There is growing concern that one of the components of value-based payments, "pay for performance," doesn't really result in increased value. Any chance that this carrot/stick approach goes away, or at least is modified significantly?
A: There is growing understanding that pay for performance programs are not the silver bullet that will solve the problem of value in health care. Here are two links that explore the pros and cons of this approach.
Q 2: Unlike your federal income taxes, payroll taxes – what likely appears on your paystub as FICA, Social Security, or Medicare – don't go into the big pot of federal funds, but instead go into trust funds - so how do these trust funds impact the deficit?
A: This is complicated and truly deep into the weeds question, so I love it. It turns out that there is a difference between “counts toward the deficit” and “contribute to the deficit.” Here is the best explanation I can find:
Q 3: How will private industry rationalize care and make it acceptable to populations at large?
A: This is a great question and I think the jury is still out. Private industry sometimes does a great job of serving the population at large and at other times contributes to the growing inequality between the haves and the have nots. I think this boils down to a very philosophical question. Does society need a safety net for health care or does the market provide a better service.
Q 4: What do payers/insurance companies need to do?
A:They need to provide value to their customers in a way that is measurable. They can find themselves odd man out if they do not keep track of how disruption is developing in health care.
Q 5: Do you have stats you could share with us about rate of hospitals closing or being gobbled up?
A: This recent testimony before the House of Representatives is the best summary of how consolidation affects health care.
Q 6: As employers jump into models such as Amazon +Berkshire +JP Morgan, do you think the future will result in gated special providers for employees of certain employers and the rest left to fend for themselves in chaos?
A: I think there is a very real possibility that employees of some companies will enjoy much different benefits than the rest of the population.