Health care premium increases for 2011 will be held to less than half of the national average, said Kyle Cavanaugh, Duke's vice president for human resources, during a Primetime employee forum on Sept. 9.
The news was delivered to about 50 faculty and staff in the Bryan Center's Griffith Theater and another 1200 tuned in at some point to watch a live online broadcast, as Cavanaugh and Dr. Mike Cuffe, vice president for medical affairs, talked about the future of health care and effect of national health care reform at Duke.
Cavanaugh said that premium increases for employees next year would have been closer to the national average if special efforts were not made by Duke this year to rein in costs of prescription drugs by creating incentives to use generic medications and mail-order for maintenance medications.
"If we had not made those changes, we'd be looking at premium increases of 10 to 15 percent," he said.
Details regarding costs and changes will be communicated in the coming weeks as part of the annual open enrollment for benefits for faculty and staff.
Both Cavanaugh and Cuffe said that while the immediate future was much more certain, national health care reform and other changes makes forecasting the next few years an uncertain business.
"We now have a law," Cavanaugh said. "But it is expected that between now and 2020, there will be over 1,000 rules, decisions and choice points that the federal government and employers will have to make."
Cuffe said that despite the uncertainty with health care reform, he felt confident that Duke University Health System is making the right investments by expanding the hospital to serve the needs of patients now and in the future.
"Moving forward, there is a lot of uncertainty in health care," he said. "It is one of the reasons why the health system was established in 1998 as a separate corporation to insulate the university from that risk ... as we continue to go through health care reform, we will be well positioned to continue to be the economic engine so the health system will survive and thrive to meet the missions as laid out for the university."
Cuffe also noted that advances in technology will continue to change the way medicine is provided, putting more responsibility for maintaining health in the hands of patients.
"We are going to see a lot more tools for managing your care at home, well beyond things like WebMD and medical dictionaries online that people use today," he said. "The competitors from my standpoint aren't just the other health care systems; it's the Microsofts and Googles and others getting into health care where they can provide a lot of tools on either side of the tradition places where you would go to get your care."
Cuffe said the health system was already using technology to improve efficiencies by offering patients an online portal to better manage their care and access their information and by creating a common medical record where a network of physicians all have access to the same patient record system to improve coordination of care and avoid duplication of services.
Such changes will also help Duke manage costs for its employee health plans. Cavanaugh said that Duke is self-insured, so individual choices about how employees consume health care affect insurance premiums. He said Duke is continuing to pay about 83 percent of an individual's premium, but noted that forecasting the future of premiums is difficult because there are still many moving parts in national health care reform.
During the forum, Cuffe and Cavanaugh also took questions from the audience. In response to one question, Cavanaugh confirmed that as part of Duke's ongoing efforts to control costs in 2011, about 100 non-Duke specialist physicians will no longer be part of the Duke Select and Duke Basic health care plan. He added that specific information and a directory of providers for next year is being mailed to employees covered by those plans so they can make informed decisions during the open enrollment period, which begins Oct. 8.
Ines Ortiz, a grants specialist from the Biomedical Engineering Department, said the Primetime event was informative. "I had no idea Duke was self-insured," she said. "That gives me a new way to think about the insurance. And it is good to know that Duke is trying hard to contain costs."