Size Means Nothing in Health Care Financing – Common Sense Does

This is what a +400,000 life group plan offering status quo healthcare strategies gets you these days…………

Choice of three plans with $3,000, $3600 and $5,500 deductibles in addition to out-of-pocket maximums. A family premium, not including any subsidies, is $16,488, $20,016 and $26,328 respectively. The most a family may end up spending is as much as $41,028 unless the cheaper plan is selected. Under that plan you would only be on the hook for $29,788 which of course would still be a family budget buster.

This plan is the TRS ActiveCare plan for Texas school districts with over 400,000 plan members.

The plan’s cost is driven by what it pays for care. The state has empowered Aetna to decide how much care costs.

Meanwhile down in deep South Texas there are two small school districts that don’t participate in the TRS ActiveCare program. Rather, these two districts with a combined total of 900 employee lives, have decided they know what health care costs truly are and pay the provider community accordingly.  It’s half the costs of what Aetna has decided the cost of care should be for the state plan.

Local control, common sense and traditional American business practices are what separates one plan with higher costs and less benefits to the other with lower costs and better benefits.

These two little tiny school districts have achieved static rates (little or no increase during the past 7 years) while improving benefits at the same time. Plus, they are over-reserved which means they can reduce rates today if they so choose.

Yet there certainly is more they can do to lower costs even more but their mindset these days is “if it ain’t broken don’t try to fix it until it is.”

This is what a small 900 life group plan incorporating common sense healthcare strategies gets you these days…………As Dave Chase has said “Health care is fixed, we only have to get it duplicated.”

(I hope I got that quote correct Dave).