Associate Executive Director

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Dr. Dan E. Ernst
800-793-6272
402-476-8055
dan@ncsa.org

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Notes from Interim Study 9/11/07
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Government, Military, and Veteran Affairs Committee
Interim Study - Health Insurance September 11, 2007

Presentation by Joseph Marlowe and Kim Lobato - AON Consulting

Notes Provided by Dr. Dan Ernst
NCSA Associate Executive Director


  • Strategies for Controlling Costs
    • Employer absorbs the increase
    • Employer shifts increase to employees
    • Reduce costs systemically

  • To avoid shifting costs to employees
    • Need to attack the root causes of high costs
    • Equip employees to participate in the decision process

  • Human capital is most important asset

  • Improve employee health to maximize asset value

  • 40% - 60% of plan costs - chronic illness
    • Allergies, arthritis, asthma, back/neck pain, breathing disorders, depression, diabetes, heart and circulatory, migraine, and stomach

  • Majority of spending growth past 15 years due to modifiable population risk factors
    • Obesity, smoking, poor diet, lack of exercise, stress
    • Obesity alone accounts for 27% of spending increase 1987-2002
    • 1/3 of population (including teenagers) are obese

  • 90% spending is for sicker population spending $1,000 + annually

  • Employers must address behavior risks and chronic illness to stand chance against expenditure growth

  • 1% of plan members account for 25% of expenditures

  • 5% of plan members account for 50% of expenditures

  • Documented problems with Healthcare System
    • Safety - 100,000 + die due to medical errors
    • Effectiveness - 50/50 chance of getting appropriate care
    • Unexplained medical practice variation -supply induced demand
    • Lack of treatment compliance worsens outcomes
    • Many people are not motivated (and need encouragement) to manage their health

  • Focus solutions on controllable elements

  • Be creative
    • Integrated health and productivity management
    • Value-based plan design
    • Quality and price transparency
    • Onsite medical center and/or pharmacy
    • Integrated data analytics

  • A growing body of evidence demonstrates that cost shifting leads to decreases in essential and non-essential care

  • Move from ones size fits all cost sharing
    • Cost sharing set on value
    • Provide financial incentive to patients most likely to benefit from specific intervention

  • Identify health and lifestyle drivers and implement health management tools

  • Promote data analytics strategy

Helping Children See a Better Tomorrow
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As part of its commitment to assuring that all Nebraska children have the opportunity for a meaningful vision evaluation, the Nebraska Foundation for Children's Vision offers free vision assessments for any 3-year-old through its SEE TO LEARN program.

A Good Place to Start.....

What is the SEE to LEARN program?

  • SEE TO LEARN is a pre-school eye care program offering free vision assessments to 3 year olds
  • SEE TO LEARN assessments are available all across Nebraska from participating Doctors of Optometry (the doctors pay an annual fee to participate in the SEE TO LEARN program)
  • A SEE TO LEARN assessment is friendly an easy. The 3 year old doesn't need to know numbers and letters because the assessment is designed just for them.
  • For children over three, it's important to schedule a complete eye exam before entering school.
  • A SEE TO LEARN assessment is a great first step in school preparation

To obtain a referral for a SEE TO LEARN vision assessment, call the Eye Care Council at 1-800-960-3937.



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