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Tuesday, April 10, 2012

Care match site to post first requests

CONCORD – A website that serves as a matchmaker between self-insured businesses and health care providers expects to post its first 30 requests from employers next week.

Open Health Market was founded in early 2011 by a doctor in California, a lawyer in New Hampshire and a former benefits manager in Maine. It was designed to cut out the middleman when it comes to health care by allowing employers to submit requests for proposals for a category of medical services and procedures – knee surgeries, for example, or cardiac care – and have health care providers submit competing bids.

At the time, officials said they would consider the venture a success if after a year it had connected one employer and one health system, and both sides were happy. But while the group heard from many employers intrigued by the idea, most were hesitant to make the leap without a bit of hand holding, said Don Crandlemire, the Concord lawyer who created the site along with Dr. Leonard Fromer of Los Angeles and Peter Hayes, former benefits manager at Scarborough, Maine-based Hannaford Bros. supermarkets.

“Employers had been extremely receptive to the concept, but the adoption of something so transformative has been slow,” he said.

Instead, the group has teamed up with Dallas-based ACAP Health, which consults with employers on strategies to reduce health costs. The company helped make the Open Health Market website more user friendly, and brought in its first batch of employers.

In the next week, 30 Texas corporations that together spend more than $1 billion on health care for more than 100,000 employees and their families will post their requests on Open Health Market, seeking information from primary-care providers, said Dr. Scott Conard, chief medical officer at ACAP Health. After a month, they’ll decide which providers they want to hear more from.

“Once you set the ground rules and the boundaries, and what the conversation is going to be focused on, it’s our experience that the two sides warm up very quickly and it becomes a fantastic conversation around the health of the employees and patients,” he said.

Nearly 60 percent of U.S. workers who have health insurance are covered by employer-funded plans, according to the Kaiser Family Foundation. Under such an arrangement, an employer assumes responsibility for the costs of employees’ medical claims, typically contracting with an insurer or third-party administrator to administer the claims.

With Open Health Market, employers negotiate directly with health care providers, potentially achieving savings that could then be passed along to employees in the form of incentives to go with the new provider, such as a waived deductible.

Critics have said such a system could lead to a focus on discounting services, rather than quality improvement. Open Health Market officials counter that quality, patient satisfaction and convenience also would be part of the negotiations, though other critics question whether employers are prepared to take on the task of evaluating providers based on quality and other factors.