Texas HB 1490 & The Lisa Plan


House Bill 1490 would require Texas hospitals to post cash prices for their services……….

Several of our clients have adopted a cash pay centric health plan. (Called The Lisa Plan). Providers are paid in cash through plan assets. Plan members pay nothing because the savings to the plan are that great. Financial barriers to healthcare are removed while saving money at the same time for both plan and members.

Deductibles are silly and actually drive up health care costs. (Everyone Is Paying For Mary’s Deductible Because Mary Isn’t).

Health providers, like the rest of us, are willing to accept less in return for cash. Cash prices beat managed care network pricing.

If 1490 becomes law we expect the cash pay model will gain market share faster than ever. (Move Over BCBS, Aetna, UHC & The Rest – Lisa Gets The Best Prices, Yours Suck)

HOSPITALS MUST POST CASH PRICES

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Lisa’s Plan

RiskManagers.us is a specialty company in the benefits market that, while not an insurance company, works directly with health entities, medical providers, and businesses to identify and develop cost effective benefits packages, emphasizing transparency and fairness in direct reimbursement compensation methods.

Bill, it has dawned on me that most of you guys promoting ways to lower health care costs are still glued to the term “Reference Based Pricing.” In some quarters that term instills fear and contempt and is a complete turnoff.

The plan we understand you will be offering the (NAME OF ASSOCIATION) should be described as a Cash Pay Program and not a Reference Based Pricing Plan. Why? Because that is exactly what your plan is, a Cash Pay centric program.

The average consumer can relate to the theory that “Cash is King.” Either they have personal experience with cash pay in dealing with health providers or they know someone who has. This “claim” methodology removes the hated insurance company from the equation, pays providers quicker and all stakeholders (Plan, Member, Provider) benefit.

No one turns down cash unless they are stupid and/or programed that they can only take payment from the payers listed in their three ring binder at the in-take clerk’s check out desk.

Those members who don’t play by the plan’s rules have the same type of plan they have always had. Deductibles, copays, coinsurance and balance billing (yes, balance billing occurs under Managed Care Plans too).

I’ve asked you and others how much will plans save by switching to a different model like this. I hear  anywhere from 15-25%. In reality isn’t it is a much greater number (30-45%)?

Proposed HB 1490 if passed will give rise to new opportunities. You can start calling your plan offering a CPN (Cash Pay Network). BTW – after 40 years of managed care consumers have become programmed to understand the word “network” equals lower prices and quality quality care. Let’s let them continue to think that way by touting CPN is the “network” with the BEST DISCOUNTS!

Molly Mulebriar

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