MEA Benefits Trust's role in providing better health care
At the Maine Education Association Benefits Trust we are very busy working on several different fronts to provide health insurance plan participants excellent coverage at an affordable price.
Your trustees are constantly reviewing the insurance plan and its components in order to maximize the plan’s effectiveness resulting in the improved health of our members.
We also work with several allied groups to improve the healthcare delivery system in Maine. It is a huge task, but it is exciting work, and it is work that uses the clout of the Association as an effective lever to motivate change.
One of the groups we work with is the Maine Health Management Coalition (MHMC), a multi-stakeholder group of unions, employers, insurers, hospitals and physicians who have united and committed themselves to improving the quality of healthcare in Maine.
The MHMC uses national quality standards and reports how effective the hospitals and doctors have been in meeting those quality standards. You can view the results on their website at http://www.mhmc.info/. This is a very important effort.
Unfortunately, prior to MHMC’s public reporting, no one reported on quality, although it was widely understood that a lack of quality was costing millions of dollars of waste in the healthcare system. On a national level, a patient gets the right treatment at the right time only 50% of the time! That is a horrible statistic.
Think of it this way: if you went to the grocery store, and you had a 50% chance of getting rancid meat or rotting produce, would you continue to go to that grocery store? No you wouldn’t. Nor should you put up with a lack of quality from your provider or hospital. Quality counts!
For most people, the thought of trying to figure out what quality care looks like in a medical setting is a daunting task. That is why the MHMC was formed. They use nationally tested metrics to determine what quality looks like.
And, through the MHMC, we simultaneously work with the physicians and hospitals to help them improve their quality. The physicians and hospitals are motivated to improve because they understand that unions and employers will create incentives for their members to use the providers with a demonstrated commitment to quality.
The State of Maine Employee Health Plan has been very successful in this effort. For several years now, the State of Maine Employee Health Plan has waived the co-pay for their members who chose providers with a demonstrated commitment to quality.
The State Employee Health Plan essentially created a preferred network of its own, in addition to the one that Anthem has. Doctors and the hospitals continue to try to improve to meet the expanding list of measures because they want to be part of the State of Maine Employee Health Plan’s preferred network.
In the next plan year, I am hopeful that the MEABT can also offer similar incentives for our members. Because our membership is almost 70,000 strong, hospitals and physicians will want to have our members use their facilities. They will strive to be part of our preferred network, and in doing so will improve their quality.
Our members will get better care and in many cases will be able to get their co-pay waived when they do so. It will be a win-win for everyone!
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