Panel Addresses Rising Costs, Consumer Health Amid Changing Landscape

Aug. 29--DURHAM -- Five leaders of some of the largest healthcare insurance providers in North Carolina agreed Thursday morning that healthcare costs would go up over the next three years.

And because of this rise in healthcare costs, panelists at the Healthcare Storm Tracker discussion said, the burden of cost control will shift to the consumer.

"The consumer needs to be asserted as a more powerful force in healthcare," said Charlie Pitts, president of Cigna's health plans in North and South Carolina.

All panelists touched on the idea of a consumer-engagement model to reduce both healthcare costs overall and health insurance premiums. The panel was hosted by employee benefits service Hill, Chesson and Woody in Durham.

Brad Wilson, president and CEO of Blue Cross and Blue Shield of North Carolina, said the health status of citizens is not as good as it should be and that the demand for health care is pushing up the cost.

"I wish everyone in America was at a healthy weight," he said.

Garland Scott, CEO for UnitedHealthcare of the Carolinas and Georgia, said that the rates of obesity and diabetes are increasing rapidly. He cited data that the diabetes rate in North Carolina is set to increase to about 25 percent of the population over the next several years.

Because of the rising prevalence of health issues and diseases, Scott said that educating and empowering consumers has a huge impact on costs.

Garland cited UnitedHealthcare's Health4Me app, which allows a consumer to access his or her health information from anywhere, as an example of consumer engagement.

"If there is an industry ripe for innovation it is certainly healthcare," Wilson said.

Attorney General Roy Cooper gave the opening remarks for the panel and discussed the changing landscape of healthcare due to the Affordable Care Act.

"One of the most pressing issues facing North Carolina is the inexplicable refusal to accept federal dollars to expand healthcare coverage to more people," Cooper, a Demcrat, said. Republican Gov. Pat McCrory and the Republican majorities in the General Assembly opposed the federal expansion.

Cooper said that North Carolina's refusal could cost the state $51 billion through 2022 and he cited data that private insurance premiums are 2 percent higher in states that do not accept federal money to expand Medicaid.

"Too many (people) are still uninsured and don't live healthy lifestyles," he said.

Seth Gross, owner of Bull City Burger and Pompieri Pizza in Durham, attended the panel and said he has around 70 employees and wants to provide them with healthcare but the cost is currently unfeasible.

He addressed the panelists and said he has been to all five of the health insurance providers present, but only two would give him quotes to insure his employees.

Melanie Womble, president and CEO of Professional Drug Screening Services in Wilson, brought up the practice of providing subsidies to employees so they can insure themselves.

But, panelists and moderators said that providing subsidies for insurance is illegal under Affordable Care Act regulations, and employers can face fines.

Tracy Baker, president of the MidSouth Market for Coventry Health Care, said because of the Affordable Care Act, there are new things happening in the market that didn't exist a year ago.

Baker said he sees the field moving into a retail environment, with private exchanges where employers can offer employees multiple carriers.

Gross disagreed with this assessment, and said he thinks insurance companies don't compete on service and that they're left competing on product and price.

"We all know if the price drops dramatically, it's coming at a cost," he said. "We don't want to go to the cheapest doctor and hope to get better."

Kenneth Lewis, president of FirstCarolinaCare, said that price is the driving factor of health insurance providers because the companies can't determine the quality of providers and the service is what you believe it is or what you find it to be.

"The goal is to provide data that is available to all of you, and to us, where the best value is," Wilson said. "That doesn't imply it's the cheapest."

Copyright 2014 - The Herald-Sun, Durham, N.C.