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Altarum's MESA Turns High-Deductible Coverage on its Head.
Managed Care (Langhorne, Pa.)
|May 16, 2018
Summary
Medical Episode Spending Allowance (MESA) benefits offer a new approach to healthcare coverage, framing it as allowances for specific care episodes. This innovative model aims to engage members in making cost-effective healthcare decisions.
Area of Science:
- Healthcare economics
- Health insurance innovation
- Patient engagement strategies
Background:
- Traditional health insurance models face challenges with rising costs.
- Consumer-directed health plans have yielded mixed results for plan sponsors.
- A need exists for novel benefit designs that encourage value-based healthcare choices.
Purpose of the Study:
- To introduce and explain the Medical Episode Spending Allowance (MESA) benefit design.
- To highlight MESA's potential to reframe healthcare coverage as episode-specific allowances.
- To outline strategies for engaging members in making informed healthcare decisions within the MESA framework.
Main Methods:
- Conceptual framework development for MESA benefits.
- Analysis of potential member engagement mechanisms.
- Evaluation of MESA's appeal to plan sponsors compared to existing models.
Main Results:
- MESA reframes healthcare coverage as allowances for defined episodes of care.
- The MESA model includes a strategy for actively engaging members in healthcare choices.
- MESA presents a potentially advantageous alternative for plan sponsors disillusioned with consumer-directed designs.
Conclusions:
- Medical Episode Spending Allowance (MESA) benefits represent a significant reframing of healthcare coverage.
- The MESA approach offers a promising strategy for member engagement and cost management.
- MESA has the potential for rapid adoption among plan sponsors seeking effective benefit designs.
Keywords:
Value-Based Tools