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Inaugural Fundamentals Course Provides Insight into Complex U.S Health Care System

HR Policy Association hosted its inaugural Fundamentals of U.S. Health Care course where attendees immersed themselves in the blueprint of the U.S health care system and explored the key stakeholders and laws that influence the employer-sponsored health care system. 

Health Care Fundamentals Course Panel

Health care benefits are a key part of the employee value proposition. The course focused on understanding the evolution of employer-sponsored health care, the complexity created by the interactions of multiple, influential stakeholders, and the design concepts behind today’s most prevalent health plans. While employees rank health care as an important part of their total compensation package, employers are under continuing pressure to balance the employee experience with rising costs. The discussions gave attendees greater insight into the perspectives and motivations of key players in the system, including insurance carriers and pharmacy benefit managers, and how those stakeholders influence outcomes for employers and employees.

The course provided key insights to understand the complexity of employer-sponsored insurance and left course attendees with an understanding of how to better negotiate with stakeholders like carriers and PBMs. Todd Bisping, Global Benefits & Health Manager, Caterpillar, Inc. provided a useful overview of the process for administering health care contracts and urged employers to think outside the box and use the information available to them to develop higher quality benefit offerings. 

Many moving parts on the policy front. Mark Wilson, President and CEO, American Health Policy Institute and Margaret Faso, Director, Health Care Policy and Research, reviewed the policy landscape, from the six major laws that provide the legal framework under which the employer health benefits operate to the major legislation currently moving in Congress including bills to increase transparency for PBMs and hospitals, modernizing HSAs, and updating mental health parity requirements. 

Employers hold more power to change the system than they currently exert. Closing out the course, members heard from Lee Lewis, Chief Strategy Officer & GM Medical Solutions, Health Transformation Alliance and Craig Lack, President, Catilize Health on how the system is set up to incentivize “bad behavior” and how employers can change those incentives. George Murphy, Executive Vice President, Commercial Marketplace, 4C Digital Health also provided an overview on how employers can use the claims data they have to reduce improper claims costs and more effectively run their health plans.

The course is the fourth offering in the Fundamentals series.  HR Policy will continue to offer our other Fundamentals courses on, U.S. and global labor relations, and executive compensation. We invite feedback on other topic areas of interest within or outside of these four offerings.

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Authors: Margaret Faso

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