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The decision to make important changes to the medical benefit for employees of The Johns Hopkins Hospital and Johns Hopkins Health System is the result of many, many decisions, and much analysis conducted over the last several years. The changes are designed to improve the health of every employee, improve employee access to the world-class care that Hopkins provides, and strengthen each of our member institutions.
After the changes are fully phased in over the next two years, the Johns Hopkins medical benefit still will be among the most substantial in the markets where Johns Hopkins operates. Most peer institutions have been at a 90/10 or 80/20 plan for several years. Many employers are moving to a 70/30 plans.
The changes to the health plan are designed to move Johns Hopkins toward leadership not only in what the plan pays, but also in how the institution operates. John Hopkins is committed to fostering the healthiest possible workplace and, as always, to continuous performance improvement. These objectives are not insignificant given rising costs and everyday challenges to good health.
While health is improving for some, the number of employees and their dependents with one or more chronic conditions is increasing. John Hopkins continues to invest in many Healthy@Hopkins programs, which include education, activities, and even financial incentives that can lead to better health. More importantly, the new health plan places significant emphasis on preventive care, paying 100 percent of the cost for visits to primary care doctors, preventive exams, diagnostic services, lab tests, most immunizations and inoculations, screenings, and allergy tests obtained within the EHP Network and at Johns Hopkins-owned hospitals. For those suffering from illness, EHP’s extensive managed care programs are proven to provide better patient outcomes.
Obviously, there is a direct correlation between improved health and lower health care costs, yet the most immediate financial impact of the new benefit for Johns Hopkins institutions lies in decisions employees may make about where to obtain care in the future.
By paying 100 percent for care received from Johns Hopkins providers and facilities, there is a clear incentive for employees to obtain care within the system. When employees stay within the system, the dollars spent on their care stay here as well. This increases the number of patients for Hopkins providers, helping to make these operations more efficient and financially sound. The direct benefit to employees is improved job security—in addition to receiving world-class care.
Gaining access to Johns Hopkins facilities and providers can sometimes be challenging. That is why a commitment has been made to introduce a preferred access program for employees to make it easier to get timely appointments and care at Hopkins. Details will be announced as this program develops.
All of this takes place in the fast-changing and challenging health care environment with which we all are familiar. Hopkins and health providers everywhere face unprecedented pressure to control costs given possible cuts in reimbursements from Medicare, Medicaid and TRICARE (military health care), and even possible cuts in research funding. This affects Johns Hopkins hospitals, clinicians, and physicians throughout the system.
Johns Hopkins new clinical buildings provide operating rooms, labor and delivery suites, a better ICU-to-acute bed ratio, and private rooms, all of which increase employment opportunities, improve working conditions for many employees, and improve our ability to deliver the best possible outcomes for patients. The Sheikh Zayed Tower and The Charlotte R. Bloomberg Children’s Center and the ongoing renovations of the historic buildings will help attract more patients and revenue from outside of the region. Nonetheless, they also bring increased fixed costs: the costs to support more clinical staffing, more security personnel and housekeepers; more space to heat and cool; along with service to construction debt.
All this complexity has prompted much analysis and reflection, and yes, some difficult decisions. Changes to the health care benefit will prompt employees to rethink health care choices and adjust to new circumstances.