Managing health care costs and improving mental health benefits will be the top priorities of U.S. employers over the next two years, according to a March 2022 survey of more than 600 companies that employ 10 million workers. The result is not surprising: The cost of health care has been a significant expense for employers for many years.
With federal mandates on what can and cannot be done in health insurance, there is not much states can do to reverse the trends. But there are policies that states can pursue that will save money and increase access to health practitioners without the need for mandates or price caps.
The past two years have put a spotlight on providing and accessing health care. States responded to the pandemic by easing regulations that restricted access to both services and providers. Such actions are likely to save lives. States can and should strengthen policies that expand patient choice, increase competition, and encourage innovation. By making the changes permanent, they are likely to help businesses and individuals save money on their health care costs.
First, states should eliminate laws that restrict nurse practitioners from working up to the full level of their education, training and certification. Last month, Kansas Gov. Laura Kelly, a Democrat, signed a law passed by the Republican-controlled legislature that allows nurse practitioners to practice independently without the supervision of a doctor. There are now 26 states including Washington, DC and two U.S. territories that allow fully independent practice authority.
People are familiar with nurse practitioners and always see them when they are sick. This is also the reason why 81 per cent of registered voters believe that health care providers should be allowed to provide services that are consistent with the full scope of their education and training. After all, nurse practitioners have received master’s or doctorate degrees and clinical training and perform a wide range of health and ethical care services. Research has shown that nurse practitioners can manage 80-90 percent of the care provided by primary care physicians. This frees up doctors to focus on 10-20 percent of patients with more complex issues.
Another opportunity for addressing health care costs, including mental health care, is to expand telehealth across state lines. States should allow patients to consult with doctors of their choice no matter where they are physically located. Almost all states require healthcare providers to obtain a license in the state where their patients are located, even if the education and training of these providers is standardized nationwide.
Millions of Americans enjoyed the benefits and cost savings of telehealth visits during the COVID-19 pandemic. The survey found that almost all owners expect to provide virtual care to meet the need for medical and ethical health services. This saves both direct costs related to the visit and indirect costs related to time, travel and work time.
And finally, 38 states are holding back much-needed competition in health care services and facilities. These restrictions – called certificate of demand (CON) laws – reduce competition and limit access to new technologies, providers, facilities and services. Decades of research on CON laws have proven that they raise costs and reduce access but do not increase the quality of services. In a remarkable action, the federal government withdrew its mandate and funding for statewide CON laws in 1987, and Washington continues to urge states to repeal these laws because of their anti-competition. character.
Businesses may not know specifically about CON laws, but they are concerned about its effects. The March survey said 73 percent of owners cited provider consolidation as a challenge to effectively delivering their health care.
Anti -competition measures – such as the scope of practice bans, bans on the use of mobile phones to see a doctor from anywhere, and CON laws – mean less competition. Lack of competition promotes consolidation, hinders innovation, and raises prices. States need to help businesses manage their health care benefit costs, especially when the pandemic has subsided and the economy has settled into what has been such a bumpy ride.
Greg George is the director of legislative affairs at Mackinac Center for Public Policya research and educational institute located in Midland, Mich.