Rather than kicking the can down the road to the next legislative session, sleepy TRS ActiveCare trustees should take note and consider adoption of newer, proven risk management strategies as other risk pools have done……………………….
8 February 2020
By Bill Rusteberg
Tired of waiting for the Texas legislature to act in addressing crippling health care costs affecting hundreds of thousands of Texas educators, the Raymondville Independent School District in deep South Texas decided to act. (Texas School District Challenges TRS ActiveCare Plan Mandates)
Established almost two decades ago, the TRS ActiveCare program covers 90% of Texas school districts and more than 400,000 plan members. Districts enrolled in the program are prohibited from leaving or offering a competing health plan.
However there is growing concern among some districts that the TRS ActiveCare program has largely failed to provide affordable and comprehensive coverage. Continued cost shifting to plan members, benefit reductions and premium increases over the past several years have fueled demands for something better.
Raymondville Independent School District decided to act. District trustees approved a new commercial health insurance plan last year to be offered alongside TRS ActiveCare. The Board of Trustees determined that districts may offer employees a choice between a commercial health plan and TRS ActiveCare through a District of Innovation (DOI) declaration.
District officials believe the new plan makes sense for Texas public school districts who are concerned about health care costs.
Managing health care on a local level brings needed accountability to health care financing while providing improved access to care and higher patient satisfaction. The new plan allows greater access to primary and specialty care by removing all financial barriers, encouraging a stronger relationship between patient and doctor.
In a press release, Stetson Roane, Superintendent of Raymondville Independent School District, said “Primary care lays the foundation of coordinated continuation of care for our members, eliminating unnecessary duplication of services and related inefficiencies common to today’s fractured health care system. Our plan will bring greater efficiency, better outcomes, and a better patient experience for our employees and their families. At the end of the day it’s all about spending our tax-supported health care dollars wisely and efficiently.”
The new plan incorporates certain proven risk management strategies designed to provide members open access to any provider of choice while offering improved benefits based on common sense, reason and logic and traditional American business practices long missing from health care financing in this country.
As a result of this new benefit option, previously uninsured employees, particularly bus drivers, custodians, cafeteria and maintenance workers have insurance for the first time.
Total plan cost is capped within budgetary constraints through risk transfer allowing for economies of scale by way of risk pooling.
It is my understanding as of this writing other districts are considering a similar move. The El Paso Independent School District has adopted the same strategies for example.
Rather than kicking the can down the road to the next legislative session, sleepy TRS ActiveCare trustees should take note and consider adoption of newer, proven risk management strategies as other risk pools have done such as the States of Montana and California.
Throwing more money down a black hole is not a good solution.
A broken health care system doesn’t need to be so and can be easily fixed. If others have solved health care, TRS ActiveCare can too. Small school districts like Rio Hondo, La Feria, and now Raymondville provide undeniable evidence that size doesn’t matter, risk management strategies do.
RiskMangers.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.