What They’re Watching: Hon. Carl Islett

Hon. Carl Islett, a retired Texas state representative, joins us in this edition of What They’re Watching to touch on incentivizing employees to become consumers.

Well in the private sector, many firms are going to reference-based pricing, doing away with networks and saying, “We will pay 150 percent of Medicare.” Medicare is a set price; everyone knows it and that limits the upper payment level of the employer.

Now, the patient can now go and say, “Doc, my plan pays 150 percent of Medicare. Will you take it?” And the doc says yes or no. He’ll say, “I’ll actually take less than that or I’ll take more than that.” The patient may find a clinic that is a cash clinic and says, “If you pay me up front, I’ll do it for half of Medicare,” or some number. And these plans can be designed in such a way to incentivize the patient to ask those questions and if they can bring it in under the price of 150, you can actually give the employee part of the savings to the plan. So it incentivizes the employee to become a consumer.