[46] in UA Exec
Re: Task Force Report: Medical copay
daemon@ATHENA.MIT.EDU (Liz Denys)
Sat Sep 19 16:55:57 2009
Date: Sat, 19 Sep 2009 16:55:25 -0400
From: Liz Denys <lizdenys@MIT.EDU>
To: hwkns@mit.edu
CC: John Hawkinson <jhawk@mit.edu>, UA Executive Board <ua-exec@mit.edu>,
CSL <ua-csl@mit.edu>, medlinks-discuss@mit.edu
In-Reply-To: <9d4f87ed0909191352sf8de71djc35e8f4e28dbb99f@mail.gmail.com>
It's unclear how copays affect the budget--especially if mandated.
This will certainly affect students. For instance, if a student needs to
see a dermatologist, they previously could at Medical for free. Now
there will be a copay. Whether this makes it an issue, on the other
hand, if it is explicitly not something Medical can decide, is unclear.
Maybe, awareness of how such decision will be made is a CSL issue?
-Liz
Daniel Hawkins wrote:
> 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
> <mailto: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 <mailto:hwkns@MIT.EDU>> wrote on
> Sat, 19 Sep 2009
> at 04:30:27 -0400 in
> <9d4f87ed0909190130y17456038xca798ada2925b27e@mail.gmail.com
> <mailto: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 <mailto: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 <mailto:jhawk@mit.edu>> wrote:
>
> Daniel Hawkins <hwkns@MIT.EDU <mailto:hwkns@MIT.EDU>>
> wrote on Sat, 19 Sep 2009
> at 04:12:12 -0400 in <
>
> 9d4f87ed0909190112k9682c64k37ec970b07f1735b@mail.gmail.com
> <mailto: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 <mailto:lizdenys@mit.edu>
>
>
--
Elizabeth A. Denys
Massachusetts Institute of Technology, Class of 2011
Department of Electrical Engineering
Department of Mathematics
630.730.1136 | lizdenys@mit.edu
