Several economic and health policy forces are converging on medical group practices that put administrative leaders in a position of finding new ways to retain and recruit clinical providers and staff while not adding to a financial pinch from rising inflation and sustained competition for workers.
Jim Holder, vice president of employee benefits consulting at Holmes Murphy & Associates and co-creator of MGMA BenefitsPlus, joined the MGMA Insights podcast to outline those forces and point to a way forward that allows organizations to bolster their offerings without breaking the bank.
Holder said that his work in employee benefit consulting for employers has recently focused on two primary motivations:
- Strategies to help lower clinical risk and costs for employers
- Improving pharmacy benefit manager (PBM) contracts for better terms and definitions that align with the clinical risk reduction strategy.
This is especially important because the hopes for lowered costs have not been realized more than a decade following the passage of the Affordable Care Act (ACA). “We continue to see hyperinflation in healthcare, both for individuals and businesses, and it’s the No. 1 expenditure for our federal government,” Holder noted.
“The last six months, the No. 1 issue [for consumers] has been inflation,” Holder added, whether that’s increased prices at the gasoline pump or the grocery store. “There are some real things that are crowding out healthcare” for individual spending, on top of the growth in out-of-pocket healthcare spending in recent years as more employees shifted into high-deductible health plans.
Holder said that medical groups and health systems as employers typically have an advantage when it comes to taking a closer look at health insurance contracts for employees, as they understand the clinical risks that often lead to poorer outcomes and higher costs. However, making investments of time to get data from insurers about what clinical elements are driving those costs is difficult to do for busy practice leaders.
This episode is sponsored by:
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