To Control Costs You Must Control Claims


In today’s ColoradoBiz digital magazine, Andrew Neary wrote this thoughtful article on self-insured businesses.  He discusses what companies can do to ensure that their goals for lower insurance costs and healthier, more productive employees are actually achieved.

My blog title is a quote from his post.  It gets to the heart of what many of us can do, right now, to help solve the problem of rising healthcare costs:





In this time of regulatory uncertainty, it’s easy to simply wait and see what happens next year.  But that doesn’t help anyone. There are things we can do right now that can improve the health of our citizens.  As businesses and care delivery organizations, we have the ability to align our interactions and incentives with the behavioral changes and outcomes.  While, we have begun this process, but still have a long way to go.


The first step on our journey to physical and fiscal behavior change is to acknowledge the current state of healthcare:

  • The majority of reimbursement is not tied to health outcomes
  • Lack of pricing transparency is counter to consumer decision processes
  • It’s easier to manage symptoms than change the causal lifestyle behaviors
  • Some stakeholders make more money managing conditions vs. curing them
  • PCPs do not have enough time to actively engage patients in lifestyle changes
  • Leisure and work time is increasingly tied to screens, instead of balls and boots
  • Our food choices are driven by convenience and profits over health and nutrition

While these issues are too big for any one organization to solve, we can all consider them as we define our strategies, products and services.  We can focus on what we can do, instead of what we cannot, or may not be able to do in the future:

  1. Technology dramatically improves our ability to help patients navigate the health system and make better choices.
  2. We can partner and engage in ways that support the alignment of incentives and the desired health and financial outcomes for all the stakeholders.
  3. We can enable new ways to engage people on their terms, and then analyze the data from these interactions, to adjust and adapt our policies, processes and care delivery strategies.

Let’s focus and take action on what we know works.  We can’t afford to wait any longer. People who engage in their health make better health decision and reduce the cost of healthcare – for everyone.  So let’s make it easier for that to happen.

Posted in: digital health, e-health, Health IT, Patient Engagment, Uncategorized

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