I attended the Annual Health Rosetta Conference in Chicago last week. There were a few hundred like-minded brokers, consultants, employers, unions, and vendors at the largest Health Rosetta Conference yet. The group has grown exponentially in the last few years, as we all want to fix the broken system that still has us purchasing health care and health insurance just like we did in the 1990’s.
To become a Certified Health Rosetta Advisor, I had to take a series of courses, curriculum, write essays and completes tests, and I’m proud to be part or a cutting edge organization that is finally bringing value to employers and their employees.
Health Rosetta is challenging the current model and making health care providers and health insurance companies accountable to every employer and covered member. There is a better way to purchase health care and health insurance. The problem is that currently everyone who could change everything for the better for all of us (insurance companies, health care providers, insurance brokers/consultants, and Big Pharma) – won’t. They make too much money with the current model.
The model that employers are investigating and implementing includes these fundamental structures:
Transparent pricing by hospitals and other providers.
Consider this: what other goods and services do we purchase every day that doesn’t give us the price of those goods and services prior to us purchasing them? Answer: None!
Fair and transparent disclosure of all compensation paid directly and indirectly to service providers .
Consider this: incentive compensation is extremely generous and under-the-table payments made to brokers/consultants by insurance companies and Pharmacy Benefit Managers as a reward to sell their products and programs is rampant. Brokers interests are clearly not aligned with employers.
Direct contracting and alternative pricing that’s fair and reasonable to medical providers.
Consider this: while insurance companies tout large PPO discounts, the reality is that these discounts are applied to ever increasing egregious pricing by hospitals. In some cases, the insurance companies keep the spread between what they’ve negotiated and what employers pay.
Independent claim administrators, Pharmacy Benefit Managers and other vendors
Consider this: rather than a “bundled” plan with an insurance company that controls all aspects of a health plan, why not “unbundle” those components and utilize Best In Class vendors who are transparent, more competitive, and provide better service?
Employer controlled data
Consider this: how could you manage any operation in your company without data to determine how well things are performing? You couldn’t. Insurance companies are notorious for holding your claims data close to the vest and disclose it with their twist. By the way, have you ever seen any information regarding member satisfaction?
Concierge care navigation
Consider this: members struggle to navigate both the provider care system as well as the rules within an insurance plan. Finding a truly qualify and distinguished provider can be a daunting task whereby no one knows where to begin, expect perhaps word of mouth. Without quality out.
If you would like to know more about how Health Rosetta programs can help you fix the broken system within your health plan, and restore
