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Stratify or Die: Employers' Perspective on Healthcare Reform

This article by Robert S. Galvin and Suzanne Delbanco explores employers' thoughts on healthcare reform, focusing on the importance of stratification, ERISA, access, cost, quality, and information.

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Stratify or Die: Employers' Perspective on Healthcare Reform

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  1. by Robert S. Galvin and Suzanne Delbanco • Three Key Points • Stratify or Die • ‘You Break It, You Own It” • Don’t Mess with ERISA • General Thoughts on Reform

  2. Do Employers Want To Preserve ESI or Find An Exit Strategy? YES

  3. Is ESI Good or Bad for the Health Care System? YES

  4. - + Responsive Innovative Not Bound By Politics Voluntary-Uninsured Portability Administrative Complexity

  5. “You Break It , You Own It” • “There’s No Such Thing as an Accident” • “Every System is Perfectly Designed to Deliver the Results It Delivers.” • One Person’s Wasteful Technology is Another Person’s Medical Miracle

  6. Don’t Mess With ERISA • ~90+ Million Americans Covered - And Satisfied • 50 Separate Benefit Designs A Costly, Administrative Nightmare • Eroding What Works To Fix What Doesn’t Is Doomed Policy Approach Employers United On This Topic

  7. Access Alone Is Not Health Reform COST QUALITY ACCESS

  8. Information Is Critical Risk-Adjusted Mortality Rate (RAMR) Hospital Columbia Presbyterian 3.93* Lenox Hill 2.26 NYU Hospitals Center 1.95 Weil Cornell – NYP 0.95* Surgeon RAMR State Total 2.25 Smith, C 4.15 *Statistically Significant Source: 1999 – 2001 NY State Hospital and Surgeon Outcomes Report

  9. Deal or No Deal: Employers More Open To Change . . . .But It Has To Help Run The Business Employer Mind-Set • Does Change Address My Specific Issue? • Will I Be Better Off? • Is Responsibility Shared? • How Do I Maintain Control?

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