Why this Stanford researcher says 1 employer health insurance model has to end

The over two-thirds of workers under employer-funded healthcare plans are being swept into a dangerously growing trend, said Alain Enthoven, PhD, a Stanford emeritus professor of public and private management.

The growing number of employer-funded healthcare models reflects employers opting for cost effectiveness at the cost of leveraging fee-for-service and not integrated delivery systems — networks that link providers clinically and fiscally to their patient population — according to Dr. Enthoven's Aug. 13 article.

Many employers are opting for self-funded approaches to step over regulations that vary on a state-by-state basis. However, Dr. Enthoven contested that mentality, as he claimed self-funded options typically result in fragmented care and incentivizing quantity of services over quality.

Currently, PPO-based products are far more popular among employer-funded healthcare models than HMOs. Dr. Enthoven argues that integrated systems push to "manage and improve" health outcomes, but because their cost savings aren't tangible to employees, they are difficult to market compared to their non-integrated counterparts.

Dr. Enthoven proposes employers learn from this and increase demand for integrated delivery systems, therein pressuring payers to offer more to employers. 

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