A group of the state’s largest employers are eager to get more detailed information about health care. In fact, they want to rate doctors and hospitals on the quality and cost of their work.
Then, they want to give patients a financial incentive to use those providers with the highest ratings.
It’s an idea that has been tried in only a few other states and health care providers here are worried.
New Hampshire Public Radio’s Dan Gorenstein has more.
New Hampshire Public Radio’s Dan Gorenstein has more.
Verizon, the Hannaford Brothers grocery chain, and a group representing local governments put out a request to health insurance companies.
They want them to offer policies that put doctors and hospitals into three groups.
Michael Bailit, a consultant to the group, says hospitals and physicians will be placed in one of these groups based on standards of quality and cost efficiency.
1:52 ... if you are rated high on quality and high on efficiency, you will have the lowest co-payment...conversely, if you rate lower on quality and lower on efficiency you will have the highest co-payment....So when a member a member looks at a directory they will see, oh, if I go to you, I will have to pay more than if I go to you.
A co-payment is the amount a patient pays when they go to see a doctor.
This approach is called a tiered plan, and Bailit believes this plan would cost employers 5-10% less than other types of coverage.
The group hopes insurance companies will entertain the idea.
3:48...We are talking about motherhood and apple pie in terms of health care...
Anthem spokesperson Clark Dumont leaves no doubt his company is interested.
....and moving us toward a system of eliminating the variables, the room for error...this is what we ought to be doing.
Dumont believes this market-based approach would give doctors and hospitals a financial incentive to ditch out-dated and ineffective procedures.
Barbara Walters, the medical director at Dartmouth/Hitchcock Clinic, in theory agrees with Dumont.
But after discussing this plan over the past year, she can also see potential problems.
16:47 in the worst of all possible worlds, if it created a competitive environment where a provider was labeled a gold versus a bronze provider, and all of the patients wanted to switch to the gold provider, there would be access issues...it would create a compettive environment that would backfire.
Walters suspects the plan is too competitive, a concern shared by other state providers.
Driving physician groups out of business is just one reason providers have been slow to warm to tiered health plans.
As one doctor pointed out, hospitals and physicians could restrict patient access if procedures or particular patient populations proved too costly.
The tiered approach is being used in Washington and California.
Glenn Mays, a senior health researcher at the Center for Studying Health System Change, says it’s too early to know if they work.
4:23 ... health plans are still in a stage of experimenting with it to determine if it contains costs or offers a lower cost product for employers and if it has any affect on quality of care or patient access to quality providers.
Mays says it is also too early to know whether people are willing to shop for healthcare they way they shop for cars or dishwashers.
He says in order for the tiered approach to have any success everyone has to agree on the rating system.
Insurance companies in New Hampshire are expected to decide whether they will offer this type of plan by the end of the month.
For NHPR News, I’m DG.
