Pamela Paulk, Sr. V.P.,
As we get ready to implement the second phase of the benefit plan redesign beginning January 2014, I wanted to take this time to thank you for your questions and comments about the changes to the medical plan. These changes impact all of us and our family members as well, so it’s important that we take this time to really understand the changes that will occur.
Beginning in 2013, Johns Hopkins made the decision to begin to transition our medical plan from 100% paid to a 90/10 co-insurance plan, if receiving care outside of Hopkins, while keeping 100% paid if the patient is seen at a Hopkins facility. In 2013 this change was kept only to inpatient care. This was done for several reasons: health care costs continue to rise and by increasing utilization of Hopkins facilities and providers we keep more of those dollars within Hopkins. This lessens the burden of the ever increasing health care costs.
What changes for 2014?
In 2014, EHP members will see the co-insurance for out-patient services the same as in-patient; members will be responsible for 10% of the cost up to the annual out-of-pocket maximum. We appreciated the feedback we received this past year and based on your comments and concerns the changes for 2014 including changes to the co-pays we pay when seeing our providers. Specialty care co-pays are lower as well as visits to in-network Urgent Care facilities.
You will continue to have 100% coverage for in-patient care if you are seen at The Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center, Howard County General Hospital, Suburban Hospital, Sibley Memorial Hospital, All-Children’s and Mt. Washington.
Physicians that are part of the Hopkins Preferred Network are Johns Hopkins Community Physicians, Johns Hopkins Clinical Practice Associates, Johns Hopkins University School of Medicine and part-time faculty medical providers.
What can we do to mitigate the cost?
The healthier we are, the lower our health care costs will be. We can take control of our individual health and our family members by utilizing the many resources we have at Hopkins and the services through the health plan, EHP. We work for a world class healthcare organization and obtaining care at Hopkins, a Hopkins owned hospital, or a Hopkins Preferred Provider will lower your costs as well. There are also many health and wellness opportunities provided through Hopkins Wellnet services.
Annual physicals, routine immunizations and other preventative services and exams are covered at 100% in-network and these are among the most important steps we can take to keep ourselves and our loved ones healthy and lower our out-of-pocket costs.
Over the past year the department administrators have worked hard to find a way to begin to improve access to Hopkins providers and services. There will be a toll free number that is sponsored by EHP for members, to help navigate the Hopkins Preferred networks for specialty visits. There will be more information during Open Enrollment on this new service, that I encourage you to utilize.
This year the Open Enrollment period for all employees at the Johns Hopkins Health System Corporation, The Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center is October 21, 2013 through November 4, 2013.
Please review the Summary of Benefits (http://www.ehp.org/sites/default/files/2014JHHSC%26JHHMedical_0.pdf) and become familiar with the changes to the plan. Keep a copy handy to refer to when you need care.
Remember, EHP provides Care Management services for patients with diabetes and asthma, COPD and cardiovascular disease as well as many other conditions. Ongoing monitoring and support is available for less complicated conditions and health coaching is available to help you reach your health goals.
Help is available
EHP representatives as well as Human Resources will be available to help explain the changes and how they may affect you and your family. This is the second phase of the benefit design change and our goal is to be there for any questions. Please let us know your feedback and questions.
Sr. Vice President, Human Resources
Johns Hopkins Medicine
Johns Hopkins Health System