HC-03-7-Health Care System Efficiency

WHEREAS CLUB 20 recognizes the importance of a competitive health care marketplace and the value of maximizing efficiency of the health care system for the benefit of consumers,

NOW, THEREFORE, BE IT RESOLVED that CLUB 20 believes that:

  • More effectively managing high cost services such as those identified in a value based benefit design should be pursued.
    • Value-Based Benefit Design is the explicit use of plan incentives to encourage enrollee adoption of one or more of the following:
  • Appropriate use of high value services, including certain prescription drugs and preventative services;
  • Adoption of healthy lifestyles, such as smoking cessation or increased physical activity, and
  • Use of high performance providers who adhere to evidence based treatment guidelines,
  • Claim forms and administrative procedures should continue to be standardized and simplified.
  • Conflicts of interest arising in the context of medical decisions or other health care delivery decisions should be eliminated and/or properly disclosed.
  • Current information regarding cost, quality and appropriateness of health care services must be accurate and readily available to payers of health care (employers, insurers, and patients) in order that they may verify fair and reasonable charges and ensure that those charges reflect actual costs.
  • A competitive marketplace for payers and health care providers is essential in order to foster cost and price consciousness.
  • Areas of excess provider coverage in the system should be reallocated or consider incentives for areas of insufficient capacity in order to provide equitable health services for all, as determined through community need, certificate of need, etc.
  • Providers who receive public funds should be required to obtain a “Certificate of Need” from an advisory panel to analyze the cost before purchasing costly medical equipment in order to discourage unnecessary and excessive investment in duplicative medical infrastructure/technologies.
  • Efforts should continue to expand the use of telemedicine as a means to increase the availability of and quality of care in a cost effective manner and to provide a more convenient alternative for rural patients.
  • Physicians should be uniformly compensated for basic procedures and services.
  • Providers should be encouraged to operate at the peak of their licensure, training and experience to ensure that they have capability in addition to formal training. The licensure process should be responsive to the needs of rural Colorado residents.

 

Adopted 9/5/2003

Amended 3/31/2006

Amended 9/9/2011

Amended 4/1/2016