As a member of a Multiple Employer Welfare Arrangement (MEWA), there are a few critical insights you should consider. Steve Bostrum of Vimly Benefit Solutions (one of MAA’s Founding Supporters), has agreed to share those with MAA readers now.

Health care is facing perhaps the greatest level of complexity in the history of the industry. The rise of consumerism, regulatory interventions, and technology applications create pressures from all sides for an organization trying to bring coherence and coordination to the point of patient care.

Moreover, many of the institutions in health care are built around legacy business models that are not readily compatible with the challenges of today. Whether that is a hospital, a health plan, or an association, sometimes these institutions are less agile than today’s market demands.

For example, if you are a MEWA, you know that you have to continue to drive administrative simplicity to your clients, both for ease of use and to bend cost trends downward. At the same time, however, you must provide new services, processes, and benefits to meet the changing demands of consumers, particularly millennials or those with multiple chronic conditions.

It’s not easy. But it’s not impossible, either.

From decades of delivering solutions for health plans and looking forward to the challenges of providing coverage to beneficiaries in 2019, we believe there are three key lessons for health plans looking to the future.

As a MEWA member, these are the three critical insights you should consider:

• Servicing evolving client needs will require greater billing simplicity, more transparency in pricing, and a better use of a technology that eases interaction. These trends are building. As an industry, successful plans are working to address these issues more rapidly than they ever have. There is a need for unified, simplified administrative interaction with members and employer-clients, so that the conversation between the plan and the beneficiary is about patient care, rather than administrative headaches.

• Increasing administrative complexity and spiking premium increases threaten strong margins in the small group market. The small group market can be difficult to manage, requires collaboration from producers, and resists efforts at coordination. In many regions, such as the Pacific Northwest, the market continues to demand provider choice as well as downward cost pressure on premiums. That’s a difficult problem to address in a legacy PPO model.

• President Trump’s executive order is reinvigorating association health plans (AHPs). There is new enthusiasm for association health plans, and for good reason. But the ease with which pre-ACA AHPs could generate margins for associations is long gone. The regulatory complexity, the administrative challenges of new benefits, and the risk modeling for the small group space are all much different than a decade ago. The most successful associations are now looking to incorporate technology tools, options among available products, and new services like expanded substance abuse and behavioral health benefits.

As a member of a MEWA or AHP, these are three critical insights you should consider, among others, of course.

This blog post was brought to MEWA Association of America readers by Steve Bostrum of Vimly Benefit Solutions. To get in touch, call 1-833-GO-VIMLY.