Time for healthcare innovation

Should the general framework of the AHCA ultimately pass, our state would have an opportunity to revise the Basic Health Plan model as a Public Option under a 1332 waiver.

The state could conceptualize a public self-insured benefit menu that advocates and both parties could agree on, tier the cost premiums up to 400 percent of the Federal Poverty Level. to the extent AHCA funding/tax credits (if any) could be integrated into the actuarial formula, and bid out the administration and risk to the extent the market could bear within a modified managed care framework. The state could consider an innovative approach to secure stop loss reinsurance at the state level or the sub-contract level, or both. The state could also consider risk stratification of the most seriously ill within the whole group and consider other innovative approaches to benefits, cost, and risk.

Point is that Washington needs to be prepared to address whatever the final outcomes of the troubling debate in the nation’s Capital ends up being and the sooner the public dialogue begins, hopefully bi-partisan, the more opportunity we will have to maximize available options and resources.

This story was originally published April 5, 2017 at 2:10 PM with the headline "Time for healthcare innovation."