May 24, 2020

Factors driving health care cost increases aired

PRESQUE ISLE – Erin Hoeflinger believes that if a silver bullet is to be found in the quagmire of rising health care costs, it lies with the people of Maine.

Hoeflinger, of Anthem Blue Cross and Blue Shield in Maine, launched the University of Maine at Presque Isle’s fall Business Associates breakfast series Tuesday morning with her talk, “Transforming the Health Care System.”

Hoeflinger was named president of the health insurance company in January 2005. She is one of the few women leading major Maine companies and is the youngest general manager of any Anthem-Wellpoint plan in the United States.

According to Hoeflinger, it is rising health care costs that are driving health insurance premiums. With the cost of care outpacing both income and inflation in the state and with a declining number of Maine employers offering health care coverage, those with private health insurance are bearing a significant burden.

Hoeflinger pointed out that because of cost shifting – private payers paying more than the actual cost for services to offset Medicare and Medicaid underpayments, bad debt and charity care – private payers spend about $1.35 for every $1 worth of services.

But one of the most significant things driving health care costs, Hoeflinger said, is the condition of Maine residents. Pointing to smoking, alcohol use, diet, exercise and genetics, Hoeflinger indicated that part of the solution rests in the hands of individuals taking charge of their own health.

“The closest thing we have to a silver bullet is us,” she said

She offered two suggestions toward that end: incorporating healthier lifestyles and increasing participation in consumer-directed health care plans.

Hoeflinger said her company is “incenting” people to maintain healthier lifestyles with a rewards program, which provides prizes for meeting diet, exercise and overall health goals.

Anthem also recently partnered with UMPI to create Journey to Wellness, a year’s worth of 60-second television spots, which will highlight healthful lifestyle habits.

The program, which will air every Tuesday and Thursday on WAGM-TV during the morning news hour, begins Nov. 1.

As for consumer-directed plans, such as health and reimbursement accounts and health savings accounts, Hoeflinger believes they are the answer for efficiency and the public’s understanding of real health care costs.

Industry officials believe that by allowing individuals greater oversight of their money, it will generate a deeper understanding of costs and what drives health care premiums.

“We want to help people make better health and health care decisions,” Hoeflinger said. “As soon as you realize it doesn’t really cost $10 to go to the doctor’s office, the world will be a better place.”

Hoeflinger earned her master of business administration degree from Xavier University in Ohio. She joined Anthem Prescription Management in 1995, where she held positions as executive director of the mail service pharmacy and executive director of client relations and operations.

In 2000, she was promoted to vice president of operations and health care management, and later to vice president of sales at Anthem Blue Cross and Blue Shield of Maine.

The company is Maine’s largest health insurer. Anthem employs 1,300 people at five facilities in Maine. The company provides health insurance coverage to 475,000 people throughout Maine and represents more than 62,000 small businesses.

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