The Plight of the Self-Funded Health Plan, in Inside Healthcare Blog

Mark Lutes, a Member of the Firm in the Health Care and Life Sciences practice, in the Washington, DC office, wrote an article titled "The Plight of the Self-Funded Health Plan."

Following is an excerpt:

There is now widespread agreement that a small percentage of patients drive a disproportionate amount of potentially avoidable healthcare costs. This is the case in all populations, commercial as well as Medicare and Medicaid, which means self-funded employers have a tremendous amount at stake relative to addressing these chronic cases — lower back pain, depression, diabetes and congestive heart failure, to name a few on most employers' list.

Given the sums at stake, one would expect that self-funded employers who bear these costs would have latched onto a range of solutions for managing the care of these "frequent flyers." The current toolbox tends to rely on wellness programs and perhaps telephonic disease management (DM). Among the employers with whom I speak, neither approach is being credited with much success. So why are additional methods not being tested?