Wellfie Wednesday Tip #121: The Greatest Trick Ever Pulled

This week’s #WellfieWednesday is brought to you by Aaron Perez (@FreestylePhysio). Enjoy! 

As I scrolled through my twitter feed Tuesday night procrastinating the writing of this blog I came across some inspiration. I had no intentions of writing a heavy post about the ongoing healthcare crisis in America, but the Vox article reminded me just of how dire the situation is. To quote Dave Chase, “Healthcare stole the American dream.” This morning I was onsite at an employer and overheard a presentation regarding the company’s open enrollment for healthcare benefits. I couldn’t help but feel like most people in the room including myself have no idea just how much we pay for healthcare. It reminds me of a well-known quote from The Usual Suspects which inspired the title of this blog“The greatest trick the devil ever pulled was convincing the world he didn’t exist.” However, in this case the quote might go something like “The greatest trick healthcare ever pulled was convincing Americans they don’t pay for healthcare.” However, thanks to soaring out of pocket costs by way of rising deductibles (212% increase over the past decade compared to 26% increase in wage growth), more and more of us are quickly realizing. They say a picture is worth 1,000 words. So, rather than me ramble on and on, below are some pictures and graphs I feel tell the tale well. If you’re looking for more of a deep dive, Dave Chase and David Goldhill do a much better job than I ever could. 

Ways We Pay

We pay in skyrocketing deductibles and premiums relative to wage growth.   Source:  https://www.kff.org/health-costs/report/2018-employer-health-benefits-survey/

We pay in skyrocketing deductibles and premiums relative to wage growth.

Source: https://www.kff.org/health-costs/report/2018-employer-health-benefits-survey/

We pay when millennials can expect to see half of their lifetime earnings go towards healthcare (and that was a conservative estimate).   Source:  Catastrophic Care  by  David Goldhill

We pay when millennials can expect to see half of their lifetime earnings go towards healthcare (and that was a conservative estimate).

Source: Catastrophic Care by David Goldhill

We pay when we sacrifice basic needs to pay for a dysfunctional healthcare system.   Source:  https://www.wsj.com/articles/burden-of-health-care-costs-moves-to-the-middle-class-1472166246

We pay when we sacrifice basic needs to pay for a dysfunctional healthcare system.

Source: https://www.wsj.com/articles/burden-of-health-care-costs-moves-to-the-middle-class-1472166246

We pay by spending more on healthcare than social services.  Source:  https://www.commonwealthfund.org/publications/issue-briefs/2015/oct/us-health-care-global-perspective

So, when will we get our return on investment? I’m not holding my breath for that moment to come. I feel like this post was a bit of a Debby-downer to say the least. That’s not typical for our #WellfieWednesday blogs, but I feel it was appropriate. On a more positive note, I hope this post raises some awareness and more so that it evokes a desire for change. Things will change, they always do. Cheers to those fighting to make that change be a positive one. I greatly admire your efforts and I’m in this with you. 

Thanks for all of the support, be sure to post your pictures this week and tag the WW crew members in your post (@TheFuelPhysio@Eric_in_AmERICa@FreestylePhysio@DianaKlatt) and keep the wave of healthy change going!

-WW Crew

Wellfie Wednesday Tip #101: Disrupting Healthcare and Delivering Hope

Happy Wellfie Wednesday! Welcome back! This week’s #WellfieWednesday post is brought to you by Aaron (@AaronPerezPT). Enjoy! 

     I recently had the privilege of co-interviewing Harris Rosen, Ashley Bacot, and Kenneth Aldridge from Rosen Hotels for the APHPT Healthcare Reboot Podcast. I’ve had a great deal of admiration for Harris since first learning about his company through Dave Chase’s excellent book, CEO’s Guide to Restoring the American Dream. It was a real honor to learn from the Rosen team and I’m grateful for the opportunity. Below is a summary of that discussion that I wanted to share with the #WellfieWednesday crowd. There is a healthcare crisis in our country, but the good news is solutions have already been created, implemented with success, and can be scaled. 

     To start, Harris shared some of his background and what motivated him to solve healthcare for his company, Rosen Hotels. Harris acknowledges his success not as miraculous, but rather pragmatic. Driven by a desire to take great care for his people, Harris and his team describe a highly proactive approach to healthcare. This is in stark contrast to the traditional reactive healthcare system we typically experience. The result is achievement of the quadruple aim: reduced cost, improved health outcomes, and much greater satisfaction amongst both patients and providers. Saving big on healthcare has allowed Rosen to invest in philanthropic efforts. Rosen has “adopted” a disadvantaged Florida neighborhood called Tangelo Park. Investment in education was a key component of this program, and the results have been astounding with significantly improved high school and college graduation rates, as well as reduced crime rates. Rosen is now scaling this program to a larger Parramore neighborhood facing similar challenges and disparities. These programs demonstrate the power of philanthropy and investing in social programs. Harris shares his dream to solve healthcare nationwide by scaling the strategies that have brought his company such great success. Imagine, a day when Americans are empowered to be true consumers of healthcare choosing among providers whom are incentivized to care greatly for improving their overall health. We share in your vision Harris!  

Key takeaways from the episode: 

  • Mindset shift: Viewing prevention and health promotion as a worthwhile investment to be leveraged, rather than a cost needing justification, is a key to success. 
  • Moreover, beyond any business metrics, investing in the health of your people is simply the right thing to do.  
  • The solutions to healthcare in the U.S. have already been discovered and are reasonably scalable. So why aren’t more companies replicating Rosen’s approach? That seems to be the 3 Trillion-dollar question.
  • While there are plenty of reasons to be cynical about the status of healthcare in the U.S., Rosen Care offers a great deal of hope. 

     Be on the lookout for the podcast to be released soon if it has not already by the time you’re reading this! I’d like to extend a HUGE THANK YOU to Harris, Kenneth, and Ashley for their time and sharing their insights and dreams! 

     Thanks again for all of the #WellfieWednesday support, be sure to post your pictures this week and tag the WW crew members in your post (@TheFuelPhysio@Eric_in_AmERICa@AaronPerezPT@DianaKlatt) and keep the wave of healthy change going!

- WW Crew

Wellfie Wednesday Tip #97: Health Literacy 101

Happy Wellfie Wednesday and Welcome back! This week’s #WellfieWednesday post is brought to you by Aaron (@AaronPerezPT). Enjoy!

Deductible…What did you just call me?!

     Lately I’ve been trying to learn more about healthcare in the United States. I’d like to say it’s been an easy learning process, but I’d be lying. I find it strange and somewhat saddening that even I, as a healthcare provider, struggle navigating the insurance world. I’m certainly not alone; a 2014 study found many Americans struggle with health insurance literacy. Historically, we have paid a lot of money for healthcare. Trends show those numbers are continuing to sky rocket and much of what we spend is becoming more “visible” to us. There also seems to be support for transforming Americans into more traditional “consumers” of healthcare. In other words, there is a push for individuals to bear more up-front costs when purchasing healthcare. It seems unreasonable to place responsibility of purchasing healthcare services on individuals without at least educating them on the basics health insurance. So, I thought a post explaining some basic insurance terms may be helpful.

Before reading further, check your current knowledge by taking this short 10 question quiz on health insurance literacy and see how you compare to other Americans.

Premium

The amount you pay monthly for health insurance. You pay this even if you do not use healthcare services. 

Deductible

The amount you pay out-of-pocket for healthcare services before your insurance starts paying. This is separate from your premium contribution. For example, if you have a $1,000 deductible, you will need to pay for the first $1,000 of any healthcare services you receive. 

In-network

These are doctors who your insurance has negotiated lower rates with than they would otherwise charge in most cases. You will typically spend less if you go to an “in-network” provider, though this may not always be the case.

Out-of-network

These are doctors who your insurance has not agreed upon a negotiated price with. Typically, you’ll pay more if you receive services from an “out-of-network provider”, though this may not always be the case.

Out-of-pocket maximum

This is the most you’ll pay for any healthcare services you receive within a given year. For example, if your out-of-pocket maximum is $7,000, once you reach this amount insurance will pay for everything else except for co-pays.  

Co-pay

A fee that you pay each time you use a specific service. This fee does not count towards your deductible. Typically, office visits (i.e. family doctor visit) carry less costly co-pays while specialty care (i.e. cardiologist) and emergency room visits carry more costly co-pays.

Co-insurance

Your plan may have a co-insurance. This is a percentage of cost you share with your insurer after your deductible is met. For example, if you have a 30% co-insurance, you will pay for 30% for healthcare services while your insurance picks up 70%. This will happen until you reach your out-of-pocket maximum, in which case insurance will cover 100%.

Here is a great summary video of some of the above info: https://www.youtube.com/watch?v=sBxLmKBqa60

     Okay, clear as mud? Hopefully this post helps someone out there understand some insurance benefit lingo a little bit better. While I generally support the idea of transforming the healthcare industry into a more consumer-driven market, there is much work to do in empowering people to be able to be true consumers of healthcare.

     Thanks again for all of the #WellfieWednesday support, be sure to post your pictures this week and tag the WW crew members in your post (@TheFuelPhysio@Eric_in_AmERICa@AaronPerezPT@DianaKlatt@kuhnalyssa_spt) and keep the wave of healthy change going!

- WW Crew