Clinton, Deputy Assistant Superintendent of the Raymondville Independent School District in deep South Texas has successfully completed his dissertation earning an Ed.D.
"This study asked why and how Raymondville ISD chose to offer an alternative to TRS ActiveCare. I interviewed five key individuals responsible for creating the Raymondville ISD partnership plan and reviewed plan documents to corroborate the interviews."
“The study revealed that Raymondville ISD chose to offer an alternative because TRS ActiveCare was not affordable to many district employees. About 1/3 of RISD employees were not covered in 2018 when TRS ActiveCare was their only option. Since 2019, the first year RISD offered an alternative pan, 100 percent of employees have had health coverage. “
“The study also showed how the district used District of Innovation to gain an exemption from TEC 22.004(i), which had precluded them from offering an alternative to TRS ActiveCare. I also identified steps taken to create the alternative plan and the pieces that were used to construct the plan. “
“Finally, I concluded that Raymondville ISD was able to offer affordable employee health coverage by using a primary care focused plan that used reference based pricing and an open network without managed care contracts. “ – Benjamin Clinton, Deputy Superintendent of the Raymondville Independent School District
RiskManagers.us
Ben’s interest in solving health care for school district employees started in 2019 when district leadership came to realize all health care is, and must be, local. They realized cost and access to care can be better addressed through collaborative partnerships between plan members and the local medical community rather than managed by bureaucrats in Austin and other third party intermediaries.
Significant factors contributing to the district’s desire to find better health insurance was a general dissatisfaction with membership in the TRS ActiveCare government health plan particularly in terms of premium costs and the cost of using the insurance both of which were beyond the means of many district employees.
The first step towards solving health care seemed insurmountable. The Raymondville Independent School District, as a member of the TRS ActiveCare government health plan was precluded by statute from exiting the program or offering a competitive commercial plan alternative alongside it.
But that didn’t stop school officials. In their research they discovered a statutory exemption which they believed would allow the district to offer a competing commercial health plan along side TRS ActiveCare.
District officials had three goals in mind: Lower Costs, Better Benefits and 100% of all full time employees covered by the district’s health insurance. The later was important because one third of all full-time employees could not afford health insurance leaving them and their families uninsured.
The search for better health care started with a risk evaluation profile of the group demographics, applied empirical data specific to similar demographics in the same geographic area, and general provider acceptance of managed care and non-managed care reimbursement rates. Experience rating was not possible because TRS ActiveCare’s policy at the time was not to release a district’s claim experience.
A team approach was adopted comprised of an outside risk manager, legal counsel, actuary, local provider organizations and an independent TPA experienced in Primary Care Centric health plan management and Cash Pay Point-of-Service claim adjudication.
A health plan alternative achieving all three goals was implemented September 1, 2019. For the first time in 20 years all full time employees were covered by affordable health insurance. All financial barriers to health care were removed including deductibles, co-pays and co-insurance for those members playing by plan rules. A majority of plan members (76%) play by the plan rules. Plan members who don’t pay a $1,000 deductible, have co-pays and co-insurance responsibilities.
Going into their third year, plan contribution rates have remained static since 2019.
Ben’s interest in solving health care for school district employees started in 2019 when district leadership came to realize all health care is, and must be, local. They realized cost and access to care can be better addressed through collaborative partnerships between plan members and the local medical community rather than managed by bureaucrats in Austin and other third party intermediaries.
Significant factors contributing to the district’s desire to find better health insurance was a general dissatisfaction with membership in the TRS ActiveCare government health plan particularly in terms of premium costs and the cost of using the insurance both of which were beyond the means of many district employees.
The first step towards solving health care seemed insurmountable. The Raymondville Independent School District, as a member of the TRS ActiveCare government health plan was precluded by statute from exiting the program or offering a competitive commercial plan alternative alongside it.
But that didn’t stop school officials. In their research they discovered a statutory exemption which they believed would allow the district to offer a competing commercial health plan along side TRS ActiveCare.
District officials had three goals in mind: Lower Costs, Better Benefits and 100% of all full time employees covered by the district’s health insurance. The later was important because one third of all full-time employees could not afford health insurance leaving them and their families uninsured.
The search for better health care started with a risk evaluation profile of the group demographics, applied empirical data specific to similar demographics in the same geographic area, and general provider acceptance of managed care and non-managed care reimbursement rates. Experience rating was not possible because TRS ActiveCare’s policy at the time was not to release a district’s claim experience.
A team approach was adopted comprised of an outside risk manager, legal counsel, actuary, local provider organizations and an independent TPA experienced in Primary Care Centric health plan management and Cash Pay Point-of-Service claim adjudication.
A health plan alternative achieving all three goals was implemented September 1, 2019. For the first time in 20 years all full time employees were covered by affordable health insurance. All financial barriers to health care were removed including deductibles, co-pays and co-insurance for those members playing by plan rules. A majority of plan members (76%) play by the plan rules. Plan members who don’t pay a $1,000 deductible, have co-pays and co-insurance responsibilities.
Going into their third year, plan contribution rates have remained static since 2019.
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11 comments:
WHO?
But who gets the cowboys games tickets from the insurance company?
#bisd
Hunter Biden?
Read this:
Before Giving Billions to Trump son-in-law Jared Kushner, Saudi Investment Fund Had Big Doubts
Before committing $2 billion to Mr. Kushner’s fledgling firm, officials at a fund led by the Saudi crown prince questioned taking such a big risk.
$2 BILLION!
¡Gracias por compartirlo! Hubiera querido estar ahÃ.
Very impressive! Mr. Clinton, you need to do that for the retired teachers in the State. They are getting screwed!
Source
Where did this story come from? You taking credit?
Someone who cares, someone who works.
Juan keep posting vote No ARENA
After relentless Republican complaints and about Hunter Biden’s international business work while his father was vice president, critics find it particularly rich that the Saudis invested a massive $2 billion in a Jared Kushner fund shortly after he left his senior adviser role in a Trump administration remarkably accommodating to the Saudis.
The money dwarfs any income Hunter Biden is known to have earned while on a Ukrainian energy company’s board while his father was Barack Obama’s vice president. And Hunter Biden couldn’t curry favor with any foreign entities with a powerful White House position like the one Kushner held, when Donald Trump’s son-in-law was supposed to be representing the American public and not his own interests.
Republicans are evil and crooked.
Twitter Loses Elon Musk the Board Member, Regains Elon Musk the Shitposter
Don't come to bisd you'll become a RATA!
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