Phyllis Borzi recently completed a HCFO project examining the wide variation among ERISA health plans. Employers and other plan sponsors believe that the flexibility they have in benefit design, as well as their ability to make structural choices are essential, allowing them to tailor health plans to their own workforce and organizational needs.

However, as Ms. Borzi notes in her issue brief if policymakers want to assure that their regulatory and legislative proposals concerning health plan design and financial liability achieve their intended goals, they need to be aware of the sources of structural variation in health plans and the legal principles that will affect accountability and liability of plan sponsors, fiduciaries, and others providing services to the group health plan. Under their HCFO grant, Ms. Borzi's project team catalogued and documented the variation among ERISA health plans, providing this much needed background and guidance to policymakers.

In addition to disseminating her HCFO work, Ms. Borzi is currently working on another project supported by The Robert Wood Johnson Foundation. For the Services Employees Union, she is exploring options for health insurance for homecare workers. Homecare workers earn relatively low wages, and in most states, they are employed directly by their clients, not by agencies or other organizations. Therefore, many currently are uninsured. A variety of administrative structures for providing insurance exist, including letting homecare workers buy-in to union's Taft-Hartley plans or state employee health plans. However, identifying financing mechanisms for the health insurance coverage is proving to be a far more difficult task.

Borzi recently finished a project for the Office of the Assistant Secretary for Planning and Evaluation (ASPE) in United States Department Health and Human Services. Through interviews with a wide-range of experts, she examined the current trends in cost and care management techniques used in the employment-based marketplace. In particular, the study focused on what drives purchasers' decision-making and the kinds of strategies that are being used by purchasers and health plans to manage health care and improve health care quality, including the use of financial incentives for providers and consumers, the adoption of clinical protocols, the development and use of quality measures, the incorporation of large case management techniques into health plan operation, and establishment of disease management programs. The report of the findings from this study is currently under review at ASPE.

Borzi received her J.D. from Catholic University Law School and currently serves as a Research Professor of Health Policy at the Center for Health Services Research and Policy, School of Public Health and Health Services, The George Washington University Medical Center. She is also a practicing lawyer at the Washington, DC law firm of O'Donoghue and O'Donoghue.