Texas Health Resources - The Business of Healthcare

The Business of Health Care Report
The Future of Managed Care - May 2002

Click to listen to this taped broadcast.

I'm Doug Hawthorne, President and CEO of Texas Health Resources, with "The Business of Health Care Report" on News Radio 1080 KRLD. Today's topic is future trends in managed care.

After a decade of dramatic change in how health care is financed, we've come to this:

The number of uninsured continues to rise.

Health Maintenance Organizations (HMOs) didn't stabilize insurance premiums for the long haul.

Hospitals and physicians suffered from low reimbursement leaving them in a hole from which they're still recovering.

Insurers went out of business or left the market because they could not find a way to medically manage claims and keep their customers.

The demand for health care services continues to rise and has not been curbed.

And there are no real-time solutions on the table to fix the situation as it exists.

But there are generalities we can communicate about what's ahead for managed care. More costs are being passed to the consumer hoping to discourage overuse habits. Watch for incentives for staying healthy, with reduced premiums for maintaining ideal weight, cholesterol and adhering to preventive screening guidelines.

The big insurance companies are selling alternative products. Some have much higher deductibles and copays, targeted to cover only extraordinary health needs. Insurers are considering trading off widely inclusive networks of physicians and hospitals, steering patients to lower cost, exclusive networks, limiting consumer choice. Insurers may provide discount incentives for surgeries and procedures during evenings and weekends when hospitals are less busy. The problem here might be whether hospitals could recruit sufficient staff and whether physicians are willing to change their practice patterns for lifestyle reasons.

Employers are in a pickle. They want out of the risk for providing expensive health benefits. Many are examining defined contribution benefit plans, where they provide an employee amount to purchase benefits on the open market. The problem? Few are selling coverage these employees need to buy, especially in the individual health insurance arena. It's not profitable business! Challenges and changes are ahead.

For Texas Health Resources and its family of hospitals - Harris Methodist Hospitals, Presbyterian Healthcare System and Arlington Memorial Hospital - I'm CEO Doug Hawthorne with "The Business of Health Care Report" on NewsRadio 1080 KRLD.

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