Transparency & being a good business partner - my interview with PrimePay

I focus this blog a lot on what needs to be fixed in the healthcare and group benefit delivery system.  Recently, I sat down with PrimePay and discussed how as consultants, we CAN change the industry, and be a good partner while doing it.  Read the interview here.  

CHIP has a 6 year reprieve, but at what cost?

As I wrote last week, The Child Health Insurance Program (CHIP) has been renewed for 6 years.  The program expired on October 1, 2017, yet Congress delayed and could not come together to give the bipartisan program a revamp.  The delay was pointless, costly, a detrimental to necessary public health initiatives for our low-income citizens.  Everyone (me, you, and our elected Congress) knew the law would ultimately pass.  

Some members of Congress did take up the good fight.  Regretfully, this fight had to mix with Repeal and Replace (twice), then hold out for further clout, and only when the government shut down did our elected officials decide what they were willing to barter in order to renew and open up funding for state CHIP plans.

Four months - a third of a year-- we let a vulnerable population teeter on the edge of medical coverage uncertainty.  Parents of pediatric patients with life-threatening conditions waited with baited breath to see if they could afford treatment for their children. 

Why was affordable health care coverage for American children unnecessarily given the run-around for so long and at what price?  This political holdout had hard and soft dollar costs that we cannot recoup - money that could have been better spent on care for our children, but instead, it ended up in waste and allowed for interruptions in care.

Let's take a look:

• The potential cost to shut down and freeze the Virginia CHIP Program in December: $300,000.  Understand that VA, AL, CO & UT were facing a 1/31/18 shut down and they needed a minimum of 6 weeks to get systems set for a shutdown.
• Even with funding being secured, as late as December 27, Carolyn Engelhard, Associate Professor at the University of VA School of Medicine said it could cost Billions.  
• VA, unsure of funding, paid $23,000 to send out letters notifying CHIP participants they may have to roll back coverage.  
• Connecticut and Colorado sent out letters as well, assuming it cost them approximately the same as Virginia, that's another $46,000 wasted.

Virginia is quite transparent with their public health spending records. Looking at the cost of a well visit for a child based in 2015 ($117) and if we increased it by 20% since the data is 3 years old, - we'll assume that today the same well visit today would cost $141.  

Let's keep it simple - those warning letters and the potential system slow down cost $323,000 in Virginia. This same money could have been used to fund ~2,290 well-child visits. 

New communications will be sent to CHIP participants that were affected (another $23k). New procedures and policies will be drafted to prevent this from happening in the future. At the end of the day, we will hear that the children were taken care of, but undeniably this whole debacle was not fiscally responsible, nor pursued with any compassion toward American families that were affected. These families will remember the stress and uncertainty of this debacle for years to come. Once a strong, functioning, and reliable government program, CHIP is now perceived as vulnerable. 

From a bird's eye view, the CHIP funding delay should be remembered as a giant waste of our tax dollars and government spending.  Isn't the goal supposed to be curbing government waste and spending?  And shouldn't we want to ensure that those at risk are protected?  

In 2018, isn't THIS something we can all stand together on?

CHIP is renewed for 6 years aka "adults acting like children while children suffer"

The Child Health Insurance Plan (CHIP) has been renewed for 6 years.    Before you bring out the noisemakers and pop the champagne, let's look at what really has happened.  

CHIP expired on October 1st, 2017 and many States have been scrambling to figure out what they are going to do.  Yes, this is a win for our children but at what price?  What will our children think of us, using their healthcare as a political game?  What costs are associated with the states that have already started to shut down or slow down their coverage options?  The costs of sending out termination letters, adding levels of stress to families dealing with critical or chronic care for their children, while facing an uncertain future?

While the news and lawmakers may rally around and give themselves a pat on the back and serve this on a tray of victory, it's not.  Our representatives should be ashamed of not finding a consensus to renew this back in October.  

If we are not going to govern like adults when it comes to our children, then what, exactly, are we governing for?