Private vs. Public Sector Thinking

I wanted to share an important insight I read in a briefing from our membership in the Advisory Board.  I think we have a tendency to think about our healthcare delivery strategy in the same way. That one size fits all. The Advisory Board article was helpful in pointing out that that private insurers do not face the same long term, large scale population health challenges that Medicare does. The Advisory Board continued noting that Private payers are focused on mitigating the costs of high-priced episodes of care, while Medicare is concerned with chronic disease management and prevention efforts.

This makes perfect sense to me when I think about how many commercial health insurance carriers I have had in my total year employment history (probably 10 or more). The point being that the commercial payers think short term and Medicare is thinking long term. As Starling’s payer mix is 50% government and 50% private pay, understanding these two very different approaches will become important. It is clear that employers through high deductible plans will continue to encourage their employees to shop more carefully for their care seeking low cost and high quality options. The Advisory Board reports that over 19% and rising of covered workers have an annual individual deductible greater then $2,000. As the Starling board heads into its strategic retreat in early December, this helpful distinction between Private and Public will be important to remember.