Promising practices in access to health care

Access to healthcare for individuals with disabilities is complicated by the lack of convergence in federal and state policies and the economic complexities of the labor market. This presentation describes three collaborative relationships among insurers, providers, and employers which have improved access to health care for people with disabilities.

In Pay for Performance Partnerships, insurers, employers, and employees share the risk and reward of cost-containment. In one notable program, hospitals and employers set aside one half of one percent of routine employee health care costs in a set-aside fund with “guarantee” and “bonus” levels assigned to four quality measures related to patient satisfaction and hospital cost-containment.

State-subsidized Reinsurance Partnerships provide coverage to insurance companies for insurance obligations beyond a specified amount. Some states fully fund the program; in others, private health insurance providers pay a premium. Public reinsurance programs reduce health insurance costs for consumers and increase coverage rates by spreading the risk of high-cost claims among insurers in the local market.

In Community-based Financing Partnerships, local community-based organizations and safety net institutions join forces to expand access, improve health outcomes, and reduce long-term costs. In one program, a university's Health Sciences Center partnered with county governments to create a network of community-based health centers. This led to a reduction in the average number of visits to specialists, emergency departments, and urgent care centers, and in the number of in-patient hospital days.