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Navigating the Health Law

By Dr. David C. Pate, News and Community
July 11, 2013


Editor’s note: The article that follows originally appeared as a column in the Idaho Statesman’s Business Insider in June.

There is plenty for everyone to dislike about the health care reform law, but businesses no longer have the luxury of debate. They must figure out how to comply and make decisions about how to control health care costs while ensuring the best possible health and productivity for their employees.

I must make those same decisions. Not only do I have to understand the critical portions of this complicated law, I am privileged to lead the largest private employer in Idaho. Here's how I am navigating these challenges for St. Luke's employees and their dependents.

Step 1: Invest in a healthier workforce.

The health care workforce is no healthier than the general population. At St. Luke's, we have implemented a health, fitness and wellness program that we call Healthy U. Our program includes health coaches, nutritionists, screenings, classes, online chats and education. We have created rewards for those who achieve their targets.

We have seen dramatic results. Not only has Healthy U resulted in significant improvements in weight, smoking cessation, control of blood pressure and control of diabetes, we have identified individuals in our workforce with serious health concerns who were not aware they had problems. In its first year, two people told me that Healthy U had saved their lives.

Step 2: Identify a trusted health care system.

Our region is blessed with several great health care systems that work with multiple health plans. Choosing a narrow network, meaning limited choices of providers, means savings to the employer.

When making your choice, ask what the provider network is doing to reduce low-value or no-value health care spending. The Institute of Medicine estimates that more than a third of all health care spending falls in this category.

Step 3: Choose a health plan.

Idaho has some very good plan choices. St. Luke's has determined that the opportunity for improved care at lower costs is most likely when physicians, hospitals and insurers all work together. They all need to share a common vision around better health, better care and lowering health care costs.

While you would think this would be commonplace, it is quite unusual. We found what we were looking for in SelectHealth, a great partner for us because it has the same commitment to share data, align incentives and work to reduce premium increases. Other health plans also are developing programs with health care systems that employers can explore to ensure strong choices for their employees.

The St. Luke's/Select-Health partnership also is paying off for other companies, including a large employer in the Magic Valley region and a smaller employer in the Wood River Valley that saw premiums cut nearly in half.

As the result of our wellness efforts, our reduction of low-value services and our relationship with SelectHealth, St. Luke's premiums went up only 3.5 percent this year, even though studies have shown that health care workers use more health care services than non-health care workers. For those who met our Healthy U targets, premiums increased only $13 for the entire year.

We don't claim to have all the answers, but we are learning some simple truths:

• Promote the health of your employees and be willing to invest in them. There is a great return.

• Partner with a provider network that will help you reduce low-value services.

• Choose a health plan that demonstrates its commitment to partnering not only with you, but with providers.


About The Author

David C. Pate, M.D., J.D., is president and CEO of St. Luke's Health System, based in Boise, Idaho. Dr. Pate joined the System in 2009. He received his medical degree from Baylor College of Medicine in Houston and his law degree from the University of Houston Law Center.