Jeff Hogan at the “Upside Effect” is the most knowledgeable person I know on the Consolidated Appropriation Act. His comment on the last post merits more attention.
The most important second order effect of CAA will be the required change in the way that employers/purchasers procure their healthcare services. Under the existing arrangement, employers rely upon agents and brokers to ‘procure’ health services from the existing BUCA (Blue Cross Blue Shield, UnitedHealth Group, Cigna, Aetna) offerings. This procurement strategy is inherently conflicted because of the way that brokers are paid for their services........commissions and contingent compensation received for the placement and retention of coverage with specific carriers. Plan fiduciaries now need to consider the fiduciary standard under CAA as the basis for considering procurement and terms. Employers and especially named fiduciaries will need to consult new informed ‘truth sources’ to help them with procurement. Further, employers will need to review their data, reporting and analytics to make appropriate buying decisions on behalf of their plan beneficiaries.
Excellent post. The CAA is a wonderful gift to the employers of this country, gladly received by every prescient CEO who understands its importance to restoring health, vitality, and significant economics - projected to be 25% to 50% or more as the dysfunction/corruption is removed - to the middle class of our country.