Mike Burns ’91 treated us to a new view of medical insurance. Mike’s firm, First Choice, works primarily with large organizations that operate “self-insured health plans”. According to Mike, over 99% of the companies with 5,000+ employees manage their own medical insurance program. And he estimated that 95% of the companies with 1,000 – 5,000 employees also operate their own “self insured health plans”.
First Choice works with these larger organizations to help them administer their internal health plans. Some of their clients include large hospitals, about 80% of the teachers in Montana, etc.
Mike introduced us to a number of emerging phrases:
He indicated that the focus is shifting to “outcomes-based medicine”. Another was the trending to become accountable care organizations”.
These larger organizations contract directly with hospitals and medical care services, so they have more direct control of their insured medical expenses. One example mentioned in relation to this was the negotiations between Boeing and medical care suppliers has resulted in most people (covered under Boeing’s plan) will have heart procedures at the Cleveland Clinic in Cleveland, Ohio.
Mike is a guy well worth a conversation if you want to know more about health coverage trends and outcomes.
You can reach Mike at firstname.lastname@example.org