How the NFL concussion settlement could help remake healthcare delivery and finance

It's not a huge surprise that last week a federal judge rejected for now the recent $760 million settlement with about 4,800 retired NFL players regarding neurological damage they may have sustained during their sports careers.

The players are intended to share in about $670 million, with some receiving sums ranging from $1.5 million to $5 million, depending on their future neurological diagnoses, according to Judge Anita B. Brody does not see how everyone who receives such a diagnosis would get the sums promised. And even if the pot of money was equally split among some 4,800 players, that works out to $139,583 apiece. If you read the pages of this website with some regularity you would know that might get a player a timeshare in a mid-level saline bag.

Brody has ordered both sides to come up with financial justifications for keeping the settlement in place, reports. Since the players--and their attorneys--want the money without prolonging litigation and the NFL wants a relatively cheap settlement,  I expect there will be some creative accounting discussions happening behind the scenes.

Yet with some actual outside-the-box thinking, the league could not only improve a public image but actually get the retired players the medical services they will need in the decades ahead--all while educating the rest of America about the high cost of healthcare in this country.

Of course, $670 million doesn't buy a lot of healthcare if you give some players large amounts and others next to nothing, or send everyone to doctors of their choosing. However, it is more than enough to fashion a delivery system tailored to the needs of the participating players. It could operate as some form of accountable care organization, with direct contracting of equipment and providers accompanied by incentives to keep costs down. Here are some of the ways they could realize savings:

1. Buying or leasing their own MRI machines. Given the nature of the players'  injuries, imaging services are going to be in high demand. The priciest MRI machine costs about $1.2 million, according to Block Imaging. Considering the cost these days for a single visit to one of these devices, only a quarter of the players would have to go through their first round of imaging before such a purchase pays for itself.

2. Contracting with preferred hospitals or medical groups. They provide a discount for care--perhaps on a capitated basis--and get to use the relationship for branding purposes. "Official provider of NFL players" would probably bring in enough other patients to make such discounting a wash. If you don't think this is ridiculous, a large laboratory in northern Virginia recently struck such an agreement with the Washington Redskins, according to an announcement from Health Diagnostic Laboratory, Inc. 

3. Providing up-close and personal documentation. A film crew could follow a cohort of players undergoing various stages of treatment and document their ordeal, with an ongoing comparison of how this differs from the way healthcare is typically delivered in the U.S. Not only would this generate revenue, it would be far more informative than the NFL films we typically see. 

Those three suggestions are only a start. There are many other, cost-effective ways to care for these groups of players and help educate the American public.

Of course, the NFL looks at its ever-growing bottom line and convinces itself it is doing just fine and nothing needs to change. The same could be said for healthcare and a variety of affiliated constituents.

This is an opportunity for both institutions to help one another out in a unique manner. I don't hold out any hopes for their doing so, but I can always dream. - Ron (@FierceHealth)