Cost, Quality, and Transparency

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Below is a brief summary of some of the core drivers that have the potential to impact the cost, quantity, and transparency of employer-provided health care.

Medical Malpractice—Reform of the medical malpractice system should contribute to the reduction of health care costs.SHRM supports efforts to strike a balance between protecting patients harmed by medical malpractice and preventing unnecessary and costly litigation that contributes to rising health care costs.Reform proposals should ensure that injured patients have timely access to legal recourse; expedited legal proceedings and fair legal fees; damages are fair and consistent; and standards of care are followed.

Cost Containment—All stakeholders, including both employers and employees, have a shared responsibility in controlling health care costs.Cost containment strategies should focus on preventing and managing chronic health care conditions that often lead to catastrophic costs for employers and employees.

Reinsurance—An alternative for sharing the risk of catastrophic and chronic health care costs is through reinsurance options, either through private reinsurance or government backed reinsurance.Key provisions for reinsurance proposals are: strengthening of the private reinsurance market; funding mechanisms; participation requirements; and the level of government involvement in any government-backed reinsurance proposal.

Health Mandates—Requiring additional health care coverage mandates would only increase health care costs, resulting in higher premiums for both employers and employees.As employee premiums rise, some workers are unable to afford this benefit and opt to forgo health care coverage, leading to more uninsured Americans.

Health Care Information—SHRM supports policies that promote greater transparency and access to information in the health care system.In order for individuals to make informed decisions about the cost-effectiveness of health care services, they must have access to provider performance measures and outcomes.Health care providers should be required to report quality information and to disclose the cost of health care procedures and outcomes.This information on the cost and quality of services will assist purchasers and consumers in choosing cost-effective health care providers and services.

Health Information Technology—Greater use of health information technology will help reduce costs and improve patient safety by reducing errors and inefficiencies in the delivery of care.SHRM supports policies that promote both public and private investment in the resources, standards, and technology needed to create an effective information network, including the creation of Electronic Health Records.

Outcomes Data—To improve health care quality, consensus must be reached on national standards for quality measurement and public reporting of health care performance data.SHRM supports efforts to promote a standard approach to measuring and reporting health care quality.

Role of HR—HR professionals can drive improvements in health care quality through their role in designing and purchasing health care for their organizations and through employee education efforts.By leveraging their buying power with other purchasers, HR professionals and employers can increase demand for better quality care, which will help control the future cost of employee health benefits.

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