[45] in UA Exec
Re: Task Force Report: Medical copay
daemon@ATHENA.MIT.EDU (Daniel Hawkins)
Sat Sep 19 16:52:27 2009
Reply-To: hwkns@MIT.EDU
In-Reply-To: <4AB4E686.7060408@mit.edu>
Date: Sat, 19 Sep 2009 16:52:12 -0400
From: Daniel Hawkins <hwkns@MIT.EDU>
To: Liz Denys <lizdenys@mit.edu>
Cc: John Hawkinson <jhawk@mit.edu>, UA Executive Board <ua-exec@mit.edu>,
CSL <ua-csl@mit.edu>, medlinks-discuss@mit.edu
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My apologies for not including the relevant context - I actually forgot that
ua-exec went to more than ua-exec-members. To clarify: There was no e-mail
to ua-exec; I had just been talking with some UA exec members about ideas in
the report that might affect student life (as a concerned student, and as a
vice chair of CSL). The idea of new copays at MIT Medical came up during
one of those conversations, so I put it on CSL's list of topics to discuss
(which is actually my list at this point - CSL hasn't even had its first
meeting yet).
My first question, more explicitly, is this: If new copays are mandated by
law and they are happening regardless of what anyone at MIT thinks, why are
they included in a list of ideas for cutting MIT's budget? For continuity?
My second question, more explicitly, is this: Is "new copays at MIT
Medical" still a student life issue? It seems to me that it will not affect
students, and that even if it did, there wouldn't be much we could do about
it.
-hwkns
On Sat, Sep 19, 2009 at 10:11 AM, Liz Denys <lizdenys@mit.edu> wrote:
> The point he really stressed was that he was not happy about this
> happening. He felt that copays would not have a positive profiting effect.
>
> 1. He stated that implementing copays would create costs on Medical's end
> that he wasn't interested in. This would be a one time, sunk cost (yay
> economics) to set up the receiving of copay because Medical right now is not
> "used to getting money" or something really similar to that.
>
> 2. More importantly/long term, he was not excited about this because he
> felt that so many people used Medical's specialty services (the non-primary
> care things which would get copays, ie. non-PCP, non-urgent?, non-OBGYN,
> non-essential to everyone possibly at some point, but the only ones I
> remember him stating for sure were OBGYN and PCP). He believes that this
> copay will serve as a tax from an economic standpoint, fewer people will use
> Medical. He also believes that so many fewer people will use Medical that it
> won't bring profit.
>
> Not sure if it's been stated yet, but he believes this will be implemented
> in January.
>
> -Liz
>
>
> John Hawkinson wrote:
>
>> Daniel Hawkins <hwkns@MIT.EDU> wrote on Sat, 19 Sep 2009
>> at 04:30:27 -0400 in <
>> 9d4f87ed0909190130y17456038xca798ada2925b27e@mail.gmail.com>:
>>
>> Yes. Thanks for filling in with better details, jhawk. The questions
>>> still
>>> stand, of course... Anyone?
>>>
>>
>> Your question was phrased such that I could not determine your point was.
>> (Not that I know the answer.) Perhaps you could be a *lot* more explicit
>> and not assume everyone has context; I don't recall seeing any email
>> to ua-exec and ua-csl is no longer a public list, and nothing in the
>> most recent UA minutes. Could someone explain the question, please?
>>
>> So, for the benefit of everyone else in the same boat as me, the only
>> mentions of "copay" (or "co-pay") in the task force report were these
>> 3 items (all from p.68 of the PDF, p.8 of the table; Administrative
>> HR/Benefits group):
>>
>>
>> ADD COPAY FOR SERVICES RECEIVED AT MIT MEDICAL FACILITY
>> Currently, there is no co-pay. Recommendation is based on a copay for
>> same visit type in commercial plan. Change will be needed to comply
>> with Mental Health Parity Act (effective 1/1/2010). The savings
>> potential is estimated at $600,000 per year, based on 60,000 visits at
>> $10 copay.
>> Recommended Action: ASSIGN: VPHR
>>
>> CONSOLIDATE CURRENT PLAN OFFERINGS TO ONE MULTIPLE TIER OFFERING
>> WITH ALL INSURED RISK IN SINGLE POOL
>> Redesign current healthcare program to consolidate current plan
>> offerings to one multiple tier offering with all insured risk in one
>> pool. Estimated annual savings potential is $200,000.
>> Recommended Action: ASSIGN: VPHR
>>
>> LEVERAGE EXCESS CAPACITY AT MIT MEDICAL
>> Provide financial incentives, through copay differentials, to
>> encourage all medical plan participants to utilize specified services
>> at MIT Medical by self-referring. MIT Medical currently has excess
>> capacity and can provide these services at a lower cost than the
>> commercial plan networks. Services include mammograms, EKG, stress
>> tests, and routine lab panels. The estimated annual savings potential
>> in combination with #5 below is $500,000. Recommended Action: ASSIGN:
>> VPHR Administrative
>>
>>
>> It's perhaps also worth pointing out that Kettyle emphasized that
>> MIT medical doesn't really like this situation:
>>
>> "We know from studies on copays that the cost of collecting them is
>> nontrivial. There is a significant cost we will incur to collect
>> copays. Having cash around is not something we're used to. We're not
>> thrilled about it. We are also not thrilled about barriers to
>> care. The most most powerful effect [of copays] is to decrease
>> utilization, not to increase revenue. It's unclear now this will play
>> out."
>>
>> --jhawk@mit.edu News Editor
>> John Hawkinson The Tech +1 617 797 0250
>> http://tech.mit.edu
>>
>> On Sat, Sep 19, 2009 at 4:20 AM, John Hawkinson <jhawk@mit.edu> wrote:
>>>
>>> Daniel Hawkins <hwkns@MIT.EDU> wrote on Sat, 19 Sep 2009
>>> at 04:12:12 -0400 in <
>>> 9d4f87ed0909190112k9682c64k37ec970b07f1735b@mail.gmail.com>:
>>> > So I went to the first open forum about the Institute Wide
>>> Planning
>>> > Task Force report, and this issue (which has been loosely assigned
>>> > to CSL) was brought up. Liz, please correct me if I'm wrong (I
>>> > didn't take notes), but I believe there was a doctor there from MIT
>>> > Medical who spoke on the issue,
>>>
>>
> --
> Elizabeth A. Denys
> Massachusetts Institute of Technology, Class of 2011
> Department of Electrical Engineering
> Department of Mathematics
> 630.730.1136 | lizdenys@mit.edu
>
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My apologies for not including the relevant context - I actually forgot tha=
t ua-exec went to more than ua-exec-members.=A0 To clarify:=A0 There was no=
e-mail to ua-exec; I had just been talking with some UA exec members about=
ideas in the report that might affect student life (as a concerned student=
, and as a vice chair of CSL).=A0 The idea of new copays at MIT Medical cam=
e up during one of those conversations, so I put it on CSL's list of to=
pics to discuss (which is actually my list at this point - CSL hasn't e=
ven had its first meeting yet).<br>
<br>My first question, more explicitly, is this:=A0 If new copays are manda=
ted by law and they are happening regardless of what anyone at MIT thinks, =
why are they included in a list of ideas for cutting MIT's budget?=A0 F=
or continuity?<br>
<br>My second question, more explicitly, is this:=A0 Is "new copays at=
MIT Medical" still a student life issue?=A0 It seems to me that it wi=
ll not affect students, and that even if it did, there wouldn't be much=
we could do about it.<br>
<br>-hwkns<br><br><br><div class=3D"gmail_quote">On Sat, Sep 19, 2009 at 10=
:11 AM, Liz Denys <span dir=3D"ltr"><<a href=3D"mailto:lizdenys@mit.edu"=
>lizdenys@mit.edu</a>></span> wrote:<br><blockquote class=3D"gmail_quote=
" style=3D"border-left: 1px solid rgb(204, 204, 204); margin: 0pt 0pt 0pt 0=
.8ex; padding-left: 1ex;">
The point he really stressed was that he was not happy about this happening=
. He felt that copays would not have a positive profiting effect.<br>
<br>
1. He stated that implementing copays would create costs on Medical's e=
nd that he wasn't interested in. This would be a one time, sunk cost (y=
ay economics) to set up the receiving of copay because Medical right now is=
not "used to getting money" or something really similar to that.=
<br>
<br>
2. More importantly/long term, he was not excited about this because he fel=
t that so many people used Medical's specialty services (the non-primar=
y care things which would get copays, ie. non-PCP, non-urgent?, non-OBGYN, =
non-essential to everyone possibly at some point, but the only ones I remem=
ber him stating for sure were OBGYN and PCP). He believes that this copay w=
ill serve as a tax from an economic standpoint, fewer people will use Medic=
al. He also believes that so many fewer people will use Medical that it won=
't bring profit.<br>
<br>
Not sure if it's been stated yet, but he believes this will be implemen=
ted in January.<br>
<br>
-Liz<div><div></div><div class=3D"h5"><br>
<br>
John Hawkinson wrote:<br>
<blockquote class=3D"gmail_quote" style=3D"border-left: 1px solid rgb(204, =
204, 204); margin: 0pt 0pt 0pt 0.8ex; padding-left: 1ex;">
Daniel Hawkins <<a href=3D"mailto:hwkns@MIT.EDU" target=3D"_blank">hwkns=
@MIT.EDU</a>> wrote on Sat, 19 Sep 2009<br>
at 04:30:27 -0400 in <<a href=3D"mailto:9d4f87ed0909190130y17456038xca79=
8ada2925b27e@mail.gmail.com" target=3D"_blank">9d4f87ed0909190130y17456038x=
ca798ada2925b27e@mail.gmail.com</a>>:<br>
<br>
<blockquote class=3D"gmail_quote" style=3D"border-left: 1px solid rgb(204, =
204, 204); margin: 0pt 0pt 0pt 0.8ex; padding-left: 1ex;">
Yes. =A0Thanks for filling in with better details, jhawk. =A0The questions =
still<br>
stand, of course... =A0Anyone?<br>
</blockquote>
<br>
Your question was phrased such that I could not determine your point was.<b=
r>
(Not that I know the answer.) Perhaps you could be a *lot* more explicit<br=
>
and not assume everyone has context; I don't recall seeing any email<br=
>
to ua-exec and ua-csl is no longer a public list, and nothing in the<br>
most recent UA minutes. Could someone explain the question, please?<br>
<br>
So, for the benefit of everyone else in the same boat as me, the only<br>
mentions of "copay" (or "co-pay") in the task force rep=
ort were these<br>
3 items (all from p.68 of the PDF, p.8 of the table; Administrative<br>
HR/Benefits group):<br>
<br>
<br>
ADD COPAY FOR SERVICES RECEIVED AT MIT MEDICAL FACILITY<br>
Currently, there is no co-pay. Recommendation is based on a copay for<br>
same visit type in commercial plan. Change will be needed to comply<br>
with Mental Health Parity Act (effective 1/1/2010). The savings<br>
potential is estimated at $600,000 per year, based on 60,000 visits at<br>
$10 copay.<br>
Recommended Action: ASSIGN: VPHR<br>
<br>
CONSOLIDATE CURRENT PLAN OFFERINGS TO ONE MULTIPLE TIER OFFERING<br>
WITH ALL INSURED RISK IN SINGLE POOL<br>
Redesign current healthcare program to consolidate current plan<br>
offerings to one multiple tier offering with all insured risk in one<br>
pool. Estimated annual savings potential is $200,000.<br>
Recommended Action: ASSIGN: VPHR<br>
<br>
LEVERAGE EXCESS CAPACITY AT MIT MEDICAL<br>
Provide financial incentives, through copay differentials, to<br>
encourage all medical plan participants to utilize specified services<br>
at MIT Medical by self-referring. MIT Medical currently has excess<br>
capacity and can provide these services at a lower cost than the<br>
commercial plan networks. Services include mammograms, EKG, stress<br>
tests, and routine lab panels. The estimated annual savings potential<br>
in combination with #5 below is $500,000. =A0Recommended Action: ASSIGN: VP=
HR Administrative<br>
<br>
<br>
It's perhaps also worth pointing out that Kettyle emphasized that<br>
MIT medical doesn't really like this situation:<br>
<br>
"We know from studies on copays that the cost of collecting them is<br=
>
nontrivial. There is a significant cost we will incur to collect<br>
copays. =A0Having cash around is not something we're used to. We're=
not<br>
thrilled about it. We are also not thrilled about barriers to<br>
care. The most most powerful effect [of copays] is to decrease<br>
utilization, not to increase revenue. It's unclear now this will play<b=
r>
out."<br>
<br>
--<a href=3D"mailto:jhawk@mit.edu" target=3D"_blank">jhawk@mit.edu</a> =A0 =
=A0 =A0 =A0 =A0 =A0 =A0 =A0 News Editor<br>
=A0John Hawkinson =A0 =A0 =A0 =A0 =A0 =A0 =A0 =A0The Tech =A0 =A0 =A0 =A0 =
=A0 =A0 =A0 =A0+1 617 797 0250<br>
=A0<a href=3D"http://tech.mit.edu" target=3D"_blank">http://tech.mit.edu</=
a><br>
<br>
<blockquote class=3D"gmail_quote" style=3D"border-left: 1px solid rgb(204, =
204, 204); margin: 0pt 0pt 0pt 0.8ex; padding-left: 1ex;">
On Sat, Sep 19, 2009 at 4:20 AM, John Hawkinson <<a href=3D"mailto:jhawk=
@mit.edu" target=3D"_blank">jhawk@mit.edu</a>> wrote:<br>
<br>
=A0 =A0Daniel Hawkins <<a href=3D"mailto:hwkns@MIT.EDU" target=3D"_blan=
k">hwkns@MIT.EDU</a>> wrote on Sat, 19 Sep 2009<br>
=A0 =A0at 04:12:12 -0400 in <<br>
=A0 =A0<a href=3D"mailto:9d4f87ed0909190112k9682c64k37ec970b07f1735b@mail.=
gmail.com" target=3D"_blank">9d4f87ed0909190112k9682c64k37ec970b07f1735b@ma=
il.gmail.com</a>>:<br>
=A0 =A0 =A0> So I went to the first open forum about the Institute Wid=
e Planning<br>
=A0 =A0> Task Force report, and this issue (which has been loosely assi=
gned<br>
=A0 =A0> to CSL) was brought up. =A0Liz, please correct me if I'm w=
rong (I<br>
=A0 =A0> didn't take notes), but I believe there was a doctor there=
from MIT<br>
=A0 =A0> Medical who spoke on the issue,<br>
</blockquote></blockquote>
<br></div></div><font color=3D"#888888">
-- <br>
Elizabeth A. Denys<br>
Massachusetts Institute of Technology, Class of 2011<br>
Department of Electrical Engineering<br>
Department of Mathematics<br>
630.730.1136 | <a href=3D"mailto:lizdenys@mit.edu" target=3D"_blank">lizden=
ys@mit.edu</a><br>
</font></blockquote></div><br>
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