32BJ Health Fund Conference Tackles Runaway Hospital Pricing

32BJ Health Fund Conference Tackles Runaway Hospital Pricing

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The 32BJ Health Fund held its fall conference Thursday to address the challenges of rising hospital prices and highlighted data-driven solutions endorsed by lawmakers and national policy experts.

The event, titled “Hospital Awards: Policy and Practice,” included keynote speakers Kyle Bragg, President of the 32BJ SEIU Union, Cora Opsahl, Director of the 32BJ Health Fund, and Dave Chase, Founder and Co-Leader of Health Rosetta, in the presence of leaders of non-profit organizations, policy experts and legislators.

32BJ Health Fund is a multi-employer fund serving more than 200,000 union members and their families, jointly governed by the union and its employers representing more than 5,000 employers who contribute to the fund. With members in more than 11 different states, the Health Fund represents the needs of essential workers who include property maintenance workers, security guards, window cleaners, construction engineers, construction workers, schools and food service and, more recently, airport workers who have been included in the 32BJ SEIU union.

“We really see the fund as our responsibility to ensure our members get high quality benefits at an affordable cost,” Opsahl said. “We have no premium sharing or deductibles for in-network care, which means that 100% of health benefits are paid for by employers. We believe it is the responsibility of the health fund to ensure affordability of delivery and not on the backs of our members.

Opsahl pointed to the painful effects of rising hospital prices, saying hospital services have increased by more than 80% since 2009 compared to drug prices which have increased by just under 30%. “Since 2004, health care has gone from 17% of total compensation to 37% of total compensation. And during that same period, salaries have increased by 54%, but health care costs have increased by 230%. To put that into a real amount – over the past 10 years, our members could have had $5,000 more in annual salaries, if health care spending had grown at the same rate as inflation,” Opsahl said.

To increase hospital accountability and counter runaway pricing, Opsahl proposes the use of new data collection tools such as RAND, NASHP and Turquoise, to highlight wasteful hospital spending practices and help identify potential savings.

“Data is at the heart of what we do. We receive all of our claims data and use it for our benefit and plan design decisions. This includes how we spend our health care dollars, what the cost of funds are for our plan design changes, and the basis for our future direction,” she said.

Opsahl further emphasized the importance of state and municipal intervention to systematically address high hospital prices and hospital behavior.

Chase, who gave the keynote, highlighted successful examples in states such as Florida, Alaska and Montana with a successful intervention on hospital pricing to highlight the restoration of “health sovereignty among the communities.

“It’s very clear, there is a better way. We have seen it succeed in every region of the country, in rural and urban settings, with small and large employers in the public and private sectors. It’s just a matter of willpower, but it’s totally doable,” Chase said. “The first element is the mindset, the second step is to optimize the planning and the structure.”

Chase highlighted the importance of codifying accurate data and navigating federal regulatory frameworks such as ERISA, to identify hidden costs and inefficiencies:

“We found that over 95% of factory owners, employers and unions have never hired an ERISA lawyer, which is the regulatory framework. They don’t look at agreements. This is actually what codifies a trillion and a half dollars in salaries. That’s why the worst result we have is an absolute 20% reduction in spending. We have swept these contracts away and the abuses that push these contractors beyond that would be unacceptable in any other area. »

As the COVID-19 pandemic has caused a surge in demands for increased hospitalization, with some communities faring worse than others due to the lack of available medical resources, Chase insisted on changing conventional perspectives on the traditional hospitalization, opting for open source hospitalization.

“I challenge you to view every hospitalization as a failure. There is administrative swelling, there is overtreatment and improper care. There are a few exceptions, but 60% of hospitalizations are preventable, if we go far enough, ahead of 90%. And there must be radical transparency and one or another of the billing possibilities. The [is progress] when people outsource care, current standards prevent a lot of that from happening,” Chase said.

Among conference attendees at 32BJ’s Manhattan headquarters, State Senator Jessica Ramos, whose district includes 32BJ union members, pointed to flaws in hospital pricing.

“This room is filled with national policy experts and people who can really help us as lawmakers do their best to overhaul a broken system,” she said. “I hope we will arrive at solution-oriented strategies that will always help inform our work as legislators.”

State Senator Gustavo Rivera, chairman of the Health Committee, also present, proposed moving to a single-payer system to deal with rising hospital prices and medical costs in general. “Pushing towards a single-payer system would actually help solve many if not all of the problems we’re talking about. Because another thing we didn’t mention was insurance. And that’s also something we definitely need to talk about.

Lawmakers at the conference seemed poised to act on predatory hospital pricing. New York City Council Member Julie Menin and Council Member Lynn Schulman said they introduced a new legislative package that would lead to the creation of an Office of Hospital Accountability.

“The [office of hospital accountability] would require hospitals to disclose their prices, there would be no comparison charts, there would be notes as to the transparency of those hospitals, there would be reporting mechanisms going to the state attorney general who can then take enforcement action,” Menin said.

As New York City spends nearly $9.5 billion in health care costs, a figure amounting to 10% of the city’s $1 billion budget, Menin insists that practices current spending is not sustainable:

“When you think of other industries, are people not getting any price information or are they sending patients to hospitals at their most vulnerable time with no information on what they are going to be charged, c is inadmissible, and this legislative package would stop putting an end to this practice.

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