What's Going On At Harvard?
Thursday, September 16, 2021
What happens when the WGU ("World's Greatest University," as Harvard is affectionately known around Boston), decides to redesign the wellness benefits programme that applies to the faculty in addition to other non-union employees? The brusk answer: A vote (pending this Tuesday) past times the Faculty of Arts in addition to Sciences to halt its implementation.
Here's a quick summary of the HMO plan:
[E]mployees would driblet dead responsible for annual deductibles of $250 per private in addition to $750 per family, in addition to coinsurance equal to 10 pct of costs, for infirmary expenses, surgeries, diagnostic testing, in addition to outpatient services, effective Jan 1, 2015. The private out-of-pocket maximum for such expenses is http,500 per year; for families, the ceiling is harvard-changes-employee-health-benefits">a quick summary of the HMO plan:
[E]mployees would driblet dead responsible for annual deductibles of $250 per private in addition to $750 per family, in addition to coinsurance equal to 10 pct of costs, for infirmary expenses, surgeries, diagnostic testing, in addition to outpatient services, effective Jan 1, 2015. The private out-of-pocket maximum for such expenses is $1,500 per year; for families, the ceiling is $4,500 (present limits are $2,000 in addition to $6,000). Above these thresholds—toward which continuing copayments for role visits in addition to prescriptions volition count, too—Harvard resumes paying 100 pct of the costs. As mandated past times the Affordable Care Act, preventive assist (annual physical in addition to gynecological exams, well-baby care, immunizations, annual screenings for cholesterol, in addition to and thus on) remains covered at 100 percent.
Before you lot jump to conclusions--thinking that people are upset exclusively because their ain benefits conduct hold been changed or their straight costs conduct hold been increased--read to a greater extent than here at the Harvard Crimson:
[History professor Mary] Lewis in addition to several other faculty members conduct hold said that they primarily conduct hold number alongside the introduction of deductibles for non-routine wellness appointments in addition to the establishment of copays upwards to $4,500 a twelvemonth for families. They fence that the novel plans are “regressive” in addition to volition disproportionately burden junior faculty members in addition to faculty members alongside families.
The Administration takes number alongside that characterization:
[Harvard President Drew} Faust, for her part, indicated that she maintains her back upwards for the novel programme inwards an interview before this month. She commended the University Benefits Committee for the assist it position into designing the plan, which she said was only finalized afterward 55 meetings of the committee.
Let's only suspension here. Fifty-five meetings!? I can't resist relating the storey of the Committee on Calendar Reform which spent 6 months trying to attain uniformity inwards the academic calendar across the diverse Harvard schools (so students could easily cross-register) in addition to failed. ("The Committee recommends that decisions concerning the adoption of mutual calendar guidelines travel deferred. . . .") At to the lowest degree here, they reached a consensus.
To continue:
Defending these changes, Faust said that inwards the past times other changes to the policy conduct hold been made to mitigate effects on employees, but that inwards social club to sustain a “generous” policy, to a greater extent than visible changes had to travel made.
Faust also challenged the assertion that the policy is “regressive,” saying, “we conduct hold quite explicit provision for lower-income employees, lower-income reaching quite high genuinely inwards what is defined as lower-income to mitigate the impact of these, in addition to I intend that prevents it from beingness regressive.”
I'm non going to opine on this back-and-forth (although nosotros could pass a lot of fourth dimension on the effects of co-pays) because I'd rather focus on a to a greater extent than subtle issue. A colleague writes:
A primal unstated motivation of the programme seems to travel to brand certain that Harvard faculty in addition to highly paid administrators tin driblet dead to the high costs Partners hospitals--as opposed to other lower cost hospitals--at no additional cost. This is implicit inwards the programme design. After you lot come across your co-pay, Harvard picks upwards the rest. So if a patient needs a physical care for that costs $100K at the BIDMC or Tufts or Lahey but $150K at MGH, at that topographic point is no deviation inwards cost to the patient. This is counter to the latest thinking on healthcare benefits, thinking that encompasses population wellness in addition to also provides effective toll signals or other incentives to utilize lower cost (and every bit high quality) providers.
These are practiced points. Many employers conduct hold offered their staff a pick of plans, including those that offering express low-cost networks. Ironically, the article cited from Harvard Magazine contains this reference:
Eckstein professor of applied economic science David M. Cutler—a sometime fellow member of the UBC, in addition to directly here at the Harvard Crimson:
[History professor Mary] Lewis in addition to several other faculty members conduct hold said that they primarily conduct hold number alongside the introduction of deductibles for non-routine wellness appointments in addition to the establishment of copays upwards to harvard-changes-employee-health-benefits">a quick summary of the HMO plan:
[E]mployees would driblet dead responsible for annual deductibles of $250 per private in addition to $750 per family, in addition to coinsurance equal to 10 pct of costs, for infirmary expenses, surgeries, diagnostic testing, in addition to outpatient services, effective Jan 1, 2015. The private out-of-pocket maximum for such expenses is $1,500 per year; for families, the ceiling is $4,500 (present limits are $2,000 in addition to $6,000). Above these thresholds—toward which continuing copayments for role visits in addition to prescriptions volition count, too—Harvard resumes paying 100 pct of the costs. As mandated past times the Affordable Care Act, preventive assist (annual physical in addition to gynecological exams, well-baby care, immunizations, annual screenings for cholesterol, in addition to and thus on) remains covered at 100 percent.
Before you lot jump to conclusions--thinking that people are upset exclusively because their ain benefits conduct hold been changed or their straight costs conduct hold been increased--read to a greater extent than here at the Harvard Crimson:
[History professor Mary] Lewis in addition to several other faculty members conduct hold said that they primarily conduct hold number alongside the introduction of deductibles for non-routine wellness appointments in addition to the establishment of copays upwards to $4,500 a twelvemonth for families. They fence that the novel plans are “regressive” in addition to volition disproportionately burden junior faculty members in addition to faculty members alongside families.
The Administration takes number alongside that characterization:
[Harvard President Drew} Faust, for her part, indicated that she maintains her back upwards for the novel programme inwards an interview before this month. She commended the University Benefits Committee for the assist it position into designing the plan, which she said was only finalized afterward 55 meetings of the committee.
Let's only suspension here. Fifty-five meetings!? I can't resist relating the storey of the Committee on Calendar Reform which spent 6 months trying to attain uniformity inwards the academic calendar across the diverse Harvard schools (so students could easily cross-register) in addition to failed. ("The Committee recommends that decisions concerning the adoption of mutual calendar guidelines travel deferred. . . .") At to the lowest degree here, they reached a consensus.
To continue:
Defending these changes, Faust said that inwards the past times other changes to the policy conduct hold been made to mitigate effects on employees, but that inwards social club to sustain a “generous” policy, to a greater extent than visible changes had to travel made.
Faust also challenged the assertion that the policy is “regressive,” saying, “we conduct hold quite explicit provision for lower-income employees, lower-income reaching quite high genuinely inwards what is defined as lower-income to mitigate the impact of these, in addition to I intend that prevents it from beingness regressive.”
I'm non going to opine on this back-and-forth (although nosotros could pass a lot of fourth dimension on the effects of co-pays) because I'd rather focus on a to a greater extent than subtle issue. A colleague writes:
A primal unstated motivation of the programme seems to travel to brand certain that Harvard faculty in addition to highly paid administrators tin driblet dead to the high costs Partners hospitals--as opposed to other lower cost hospitals--at no additional cost. This is implicit inwards the programme design. After you lot come across your co-pay, Harvard picks upwards the rest. So if a patient needs a physical care for that costs $100K at the BIDMC or Tufts or Lahey but $150K at MGH, at that topographic point is no deviation inwards cost to the patient. This is counter to the latest thinking on healthcare benefits, thinking that encompasses population wellness in addition to also provides effective toll signals or other incentives to utilize lower cost (and every bit high quality) providers.
These are practiced points. Many employers conduct hold offered their staff a pick of plans, including those that offering express low-cost networks. Ironically, the article cited from Harvard Magazine contains this reference:
Eckstein professor of applied economic science David M. Cutler—a sometime fellow member of the UBC, in addition to directly Committee on Calendar Reform which spent 6 months trying to attain uniformity inwards the academic calendar across the diverse Harvard schools (so students could easily cross-register) in addition to failed. ("The Committee recommends that decisions concerning the adoption of mutual calendar guidelines travel deferred. . . .") At to the lowest degree here, they reached a consensus.
To continue:
Defending these changes, Faust said that inwards the past times other changes to the policy conduct hold been made to mitigate effects on employees, but that inwards social club to sustain a “generous” policy, to a greater extent than visible changes had to travel made.
Faust also challenged the assertion that the policy is “regressive,” saying, “we conduct hold quite explicit provision for lower-income employees, lower-income reaching quite high genuinely inwards what is defined as lower-income to mitigate the impact of these, in addition to I intend that prevents it from beingness regressive.”
I'm non going to opine on this back-and-forth (although nosotros could pass a lot of fourth dimension on the effects of co-pays) because I'd rather focus on a to a greater extent than subtle issue. A colleague writes:
A primal unstated motivation of the programme seems to travel to brand certain that Harvard faculty in addition to highly paid administrators tin driblet dead to the high costs Partners hospitals--as opposed to other lower cost hospitals--at no additional cost. This is implicit inwards the programme design. After you lot come across your co-pay, Harvard picks upwards the rest. So if a patient needs a physical care for that costs $100K at the BIDMC or Tufts or Lahey but $150K at MGH, at that topographic point is no deviation inwards cost to the patient. This is counter to the latest thinking on healthcare benefits, thinking that encompasses population wellness in addition to also provides effective toll signals or other incentives to utilize lower cost (and every bit high quality) providers.
These are practiced points. Many employers conduct hold offered their staff a pick of plans, including those that offering express low-cost networks. Ironically, the article cited from Harvard Magazine contains this reference:
Eckstein professor of applied economic science David M. Cutler—a sometime fellow member of the UBC, in addition to directly a fellow member of the Massachusetts Health Policy Commission (an independent way charged alongside developing policies to trim back the growth of healthcare costs in addition to improve the character of care)—has written extensively well-nigh this mechanism. Last December, inwards the New England Journal of Medicine, he in addition to 2 coauthors—writing well-nigh the deceleration inwards the growth of US of America healthcare spending—observed that patients could travel rewarded “for choosing providers in addition to organizational arrangements…that are associated alongside amend outcomes in addition to lower costs of care. Tiered networks establish an early on version of this approach to consumer engagement.” A calendar month earlier, inwards “Hospitals, Market Share, in addition to Consolidation,” published inwards the Journal of the American Medical Association, Cutler in addition to Fiona Scott Morton (of the Yale School of Management) wrote of tertiary-care institutions, “[F]lagship academic medical centers offering perceived higher character assist oftentimes wield enormous marketplace power.” They cited a study past times the Massachusetts attorney general finding broad differences inwards pricing but “no correlation betwixt infirmary toll in addition to quality” inwards Harvard’s marketplace area. Cutler in addition to Morton advise insurance programs alongside differential cost-sharing: “routine operation could involve higher consumer cost sharing if provided at the dominant wellness scheme inwards a marketplace than inwards a less expensive one”—a tiered network.
But the UBC decided to foreclose this opportunity. Why? I clearly did non attend whatsoever of the 55 meetings, but I bet ane argue was that tiered options would unmarried out some of the Harvard-affiliated hospitals as beingness amidst the highest cost inwards the region. How embarassing or awkward would that be, for the University to brand transparent that some hospitals associated alongside Harvard Medical School offering less value to patients in addition to families than others? Instead, inwards going downwards this lowest mutual denominator path, the UBC has built inwards unnecessarily high wellness assist costs for the University.
Here's a quick summary of the HMO plan:
[E]mployees would driblet dead responsible for annual deductibles of $250 per private in addition to $750 per family, in addition to coinsurance equal to 10 pct of costs, for infirmary expenses, surgeries, diagnostic testing, in addition to outpatient services, effective Jan 1, 2015. The private out-of-pocket maximum for such expenses is http,500 per year; for families, the ceiling is harvard-changes-employee-health-benefits">a quick summary of the HMO plan:
[E]mployees would driblet dead responsible for annual deductibles of $250 per private in addition to $750 per family, in addition to coinsurance equal to 10 pct of costs, for infirmary expenses, surgeries, diagnostic testing, in addition to outpatient services, effective Jan 1, 2015. The private out-of-pocket maximum for such expenses is $1,500 per year; for families, the ceiling is $4,500 (present limits are $2,000 in addition to $6,000). Above these thresholds—toward which continuing copayments for role visits in addition to prescriptions volition count, too—Harvard resumes paying 100 pct of the costs. As mandated past times the Affordable Care Act, preventive assist (annual physical in addition to gynecological exams, well-baby care, immunizations, annual screenings for cholesterol, in addition to and thus on) remains covered at 100 percent.
Before you lot jump to conclusions--thinking that people are upset exclusively because their ain benefits conduct hold been changed or their straight costs conduct hold been increased--read to a greater extent than here at the Harvard Crimson:
[History professor Mary] Lewis in addition to several other faculty members conduct hold said that they primarily conduct hold number alongside the introduction of deductibles for non-routine wellness appointments in addition to the establishment of copays upwards to $4,500 a twelvemonth for families. They fence that the novel plans are “regressive” in addition to volition disproportionately burden junior faculty members in addition to faculty members alongside families.
The Administration takes number alongside that characterization:
[Harvard President Drew} Faust, for her part, indicated that she maintains her back upwards for the novel programme inwards an interview before this month. She commended the University Benefits Committee for the assist it position into designing the plan, which she said was only finalized afterward 55 meetings of the committee.
Let's only suspension here. Fifty-five meetings!? I can't resist relating the storey of the Committee on Calendar Reform which spent 6 months trying to attain uniformity inwards the academic calendar across the diverse Harvard schools (so students could easily cross-register) in addition to failed. ("The Committee recommends that decisions concerning the adoption of mutual calendar guidelines travel deferred. . . .") At to the lowest degree here, they reached a consensus.
To continue:
Defending these changes, Faust said that inwards the past times other changes to the policy conduct hold been made to mitigate effects on employees, but that inwards social club to sustain a “generous” policy, to a greater extent than visible changes had to travel made.
Faust also challenged the assertion that the policy is “regressive,” saying, “we conduct hold quite explicit provision for lower-income employees, lower-income reaching quite high genuinely inwards what is defined as lower-income to mitigate the impact of these, in addition to I intend that prevents it from beingness regressive.”
I'm non going to opine on this back-and-forth (although nosotros could pass a lot of fourth dimension on the effects of co-pays) because I'd rather focus on a to a greater extent than subtle issue. A colleague writes:
A primal unstated motivation of the programme seems to travel to brand certain that Harvard faculty in addition to highly paid administrators tin driblet dead to the high costs Partners hospitals--as opposed to other lower cost hospitals--at no additional cost. This is implicit inwards the programme design. After you lot come across your co-pay, Harvard picks upwards the rest. So if a patient needs a physical care for that costs $100K at the BIDMC or Tufts or Lahey but $150K at MGH, at that topographic point is no deviation inwards cost to the patient. This is counter to the latest thinking on healthcare benefits, thinking that encompasses population wellness in addition to also provides effective toll signals or other incentives to utilize lower cost (and every bit high quality) providers.
Eckstein professor of applied economic science David M. Cutler—a sometime fellow member of the UBC, in addition to directly here at the Harvard Crimson:
[History professor Mary] Lewis in addition to several other faculty members conduct hold said that they primarily conduct hold number alongside the introduction of deductibles for non-routine wellness appointments in addition to the establishment of copays upwards to harvard-changes-employee-health-benefits">a quick summary of the HMO plan:
[E]mployees would driblet dead responsible for annual deductibles of $250 per private in addition to $750 per family, in addition to coinsurance equal to 10 pct of costs, for infirmary expenses, surgeries, diagnostic testing, in addition to outpatient services, effective Jan 1, 2015. The private out-of-pocket maximum for such expenses is $1,500 per year; for families, the ceiling is $4,500 (present limits are $2,000 in addition to $6,000). Above these thresholds—toward which continuing copayments for role visits in addition to prescriptions volition count, too—Harvard resumes paying 100 pct of the costs. As mandated past times the Affordable Care Act, preventive assist (annual physical in addition to gynecological exams, well-baby care, immunizations, annual screenings for cholesterol, in addition to and thus on) remains covered at 100 percent.
Before you lot jump to conclusions--thinking that people are upset exclusively because their ain benefits conduct hold been changed or their straight costs conduct hold been increased--read to a greater extent than here at the Harvard Crimson:
[History professor Mary] Lewis in addition to several other faculty members conduct hold said that they primarily conduct hold number alongside the introduction of deductibles for non-routine wellness appointments in addition to the establishment of copays upwards to $4,500 a twelvemonth for families. They fence that the novel plans are “regressive” in addition to volition disproportionately burden junior faculty members in addition to faculty members alongside families.
The Administration takes number alongside that characterization:
[Harvard President Drew} Faust, for her part, indicated that she maintains her back upwards for the novel programme inwards an interview before this month. She commended the University Benefits Committee for the assist it position into designing the plan, which she said was only finalized afterward 55 meetings of the committee.
Let's only suspension here. Fifty-five meetings!? I can't resist relating the storey of the Committee on Calendar Reform which spent 6 months trying to attain uniformity inwards the academic calendar across the diverse Harvard schools (so students could easily cross-register) in addition to failed. ("The Committee recommends that decisions concerning the adoption of mutual calendar guidelines travel deferred. . . .") At to the lowest degree here, they reached a consensus.
To continue:
Defending these changes, Faust said that inwards the past times other changes to the policy conduct hold been made to mitigate effects on employees, but that inwards social club to sustain a “generous” policy, to a greater extent than visible changes had to travel made.
Faust also challenged the assertion that the policy is “regressive,” saying, “we conduct hold quite explicit provision for lower-income employees, lower-income reaching quite high genuinely inwards what is defined as lower-income to mitigate the impact of these, in addition to I intend that prevents it from beingness regressive.”
I'm non going to opine on this back-and-forth (although nosotros could pass a lot of fourth dimension on the effects of co-pays) because I'd rather focus on a to a greater extent than subtle issue. A colleague writes:
A primal unstated motivation of the programme seems to travel to brand certain that Harvard faculty in addition to highly paid administrators tin driblet dead to the high costs Partners hospitals--as opposed to other lower cost hospitals--at no additional cost. This is implicit inwards the programme design. After you lot come across your co-pay, Harvard picks upwards the rest. So if a patient needs a physical care for that costs $100K at the BIDMC or Tufts or Lahey but $150K at MGH, at that topographic point is no deviation inwards cost to the patient. This is counter to the latest thinking on healthcare benefits, thinking that encompasses population wellness in addition to also provides effective toll signals or other incentives to utilize lower cost (and every bit high quality) providers.
Eckstein professor of applied economic science David M. Cutler—a sometime fellow member of the UBC, in addition to directly Committee on Calendar Reform which spent 6 months trying to attain uniformity inwards the academic calendar across the diverse Harvard schools (so students could easily cross-register) in addition to failed. ("The Committee recommends that decisions concerning the adoption of mutual calendar guidelines travel deferred. . . .") At to the lowest degree here, they reached a consensus.
To continue:
Defending these changes, Faust said that inwards the past times other changes to the policy conduct hold been made to mitigate effects on employees, but that inwards social club to sustain a “generous” policy, to a greater extent than visible changes had to travel made.
Faust also challenged the assertion that the policy is “regressive,” saying, “we conduct hold quite explicit provision for lower-income employees, lower-income reaching quite high genuinely inwards what is defined as lower-income to mitigate the impact of these, in addition to I intend that prevents it from beingness regressive.”
I'm non going to opine on this back-and-forth (although nosotros could pass a lot of fourth dimension on the effects of co-pays) because I'd rather focus on a to a greater extent than subtle issue. A colleague writes:
A primal unstated motivation of the programme seems to travel to brand certain that Harvard faculty in addition to highly paid administrators tin driblet dead to the high costs Partners hospitals--as opposed to other lower cost hospitals--at no additional cost. This is implicit inwards the programme design. After you lot come across your co-pay, Harvard picks upwards the rest. So if a patient needs a physical care for that costs $100K at the BIDMC or Tufts or Lahey but $150K at MGH, at that topographic point is no deviation inwards cost to the patient. This is counter to the latest thinking on healthcare benefits, thinking that encompasses population wellness in addition to also provides effective toll signals or other incentives to utilize lower cost (and every bit high quality) providers.
Eckstein professor of applied economic science David M. Cutler—a sometime fellow member of the UBC, in addition to directly a fellow member of the Massachusetts Health Policy Commission (an independent way charged alongside developing policies to trim back the growth of healthcare costs in addition to improve the character of care)—has written extensively well-nigh this mechanism. Last December, inwards the New England Journal of Medicine, he in addition to 2 coauthors—writing well-nigh the deceleration inwards the growth of US of America healthcare spending—observed that patients could travel rewarded “for choosing providers in addition to organizational arrangements…that are associated alongside amend outcomes in addition to lower costs of care. Tiered networks establish an early on version of this approach to consumer engagement.” A calendar month earlier, inwards “Hospitals, Market Share, in addition to Consolidation,” published inwards the Journal of the American Medical Association, Cutler in addition to Fiona Scott Morton (of the Yale School of Management) wrote of tertiary-care institutions, “[F]lagship academic medical centers offering perceived higher character assist oftentimes wield enormous marketplace power.” They cited a study past times the Massachusetts attorney general finding broad differences inwards pricing but “no correlation betwixt infirmary toll in addition to quality” inwards Harvard’s marketplace area. Cutler in addition to Morton advise insurance programs alongside differential cost-sharing: “routine operation could involve higher consumer cost sharing if provided at the dominant wellness scheme inwards a marketplace than inwards a less expensive one”—a tiered network.
But the UBC decided to foreclose this opportunity. Why? I clearly did non attend whatsoever of the 55 meetings, but I bet ane argue was that tiered options would unmarried out some of the Harvard-affiliated hospitals as beingness amidst the highest cost inwards the region. How embarassing or awkward would that be, for the University to brand transparent that some hospitals associated alongside Harvard Medical School offering less value to patients in addition to families than others? Instead, inwards going downwards this lowest mutual denominator path, the UBC has built inwards unnecessarily high wellness assist costs for the University.