Extreme Healthcare Chaos

Stethoscope with American Flag Reflection on Wooden Table.

Turmoil by executive order again… On Thursday, President Trump threw two more giant logs on the raging healthcare marketplace fire by ordering the discontinuance of federal funding for cost-sharing subsides for low income Americans and by directing the Secretary of Labor to provide guidance on liberalizing association healthcare plan rules. Cost-sharing subsidies made healthcare affordable… [Read More]

Getting Creative in Combating Rising Specialty Drug Costs

Pills dollar symbol

High cost drugs are the most significant cost driver in healthcare today. Because of their therapeutic value (they cure illness), it is very difficult to manage the cost of these specialty medications. Prior approval, quantity limits and high cost-sharing have proven to be among the most effective utilization mechanisms. A study published in The Journal… [Read More]

Insurance Carriers Reducing the Cost of Care

Man at the table fills in the form of health insurance. Healthcare concept. Vector illustration flat design style. Life planning. Claim form. Medical equipment, money, prescription medications.

This week I am attending the Cigna National Producer Advisory meeting. I am pleased to say that Cigna, as well as all the national insurance carriers, are busy moving forward the goal of reducing healthcare costs by aligning interests. Physicians will receive additional compensation if results establish quality care, a favorable member experience and affordability… [Read More]

2017 Kaiser Family Foundation Survey Results

medical cost, stethoscope on dollar banknote money. concept of health care costs, finance, health insurance fund.

Kaiser has just published its 2017 annual benefits survey and I think the folks in Washington, D.C. all need a copy. Approximately half of the United States’ non-elderly population gets healthcare coverage through their employer, so this survey reveals what many Americans are experiencing. While employer coverage is far better, in many respects, than the coverage… [Read More]

Healthcare Reform… More of the Same

Healthcare in the Trump Era Takes Its First Step

The Senate is making one last-gasp effort to repeal ACA… Well, not actually repeal, just reconfigure. Lindsey Graham and Bill Cassidy have sponsored a bill, which will be eligible for consideration under budget reconciliation rules (i.e. 51 votes required to pass and not subject to filibuster). Under the bill the amounts paid by the federal… [Read More]

Reviewing Contracts: An Essential Part of Health Plan Management

Reviewing Contracts An Essential Part of Health Plan Management

And you thought it was tough to decide on plan design, communication strategy and contributions for your medical benefits plan… Once the crush of implementation begins, the plan documents will start coming to your inbox and it’s critically important that you understand them completely. The obvious first steps would be to check the principal plan… [Read More]

Another Blow to the Healthcare Exchanges as CareConnect Shutters

No Easy Answers Another Blow to Healthcare as CareConnect Shutters

CareConnect, the upstart insurance company founded in 2014 by Northwell Health in the Downstate New York marketplace, has made the decision to cease operations. It made a lot of sense that Northwell, a hospital chain with extensive provider connections, could cut out the middleman insurance company and offer insurance protection directly to its customers. It didn’t… [Read More]

States Petition to Chart Their Own Healthcare Course

States Petition to Chart Their Own Healthcare Course

­­The Trump administration has indicated a willingness to liberalize the Section 1332 State Innovation Waiver under the Affordable Care Act (ACA) to make it easier for states to provide affordable coverage. So far, only Hawaii has been granted the ability to deviate from the ACA, but now Iowa will be testing the President’s stomach on… [Read More]

What to Expect for 2018 Premium Increases

What to Expect for 2018 Premium Increases

UBS released its 2018 Large Employer Health Benefits Survey and the results are encouraging. Premium equivalents for this largely self-insured study group are expected to rise 6.1% on average from 2017. Interestingly, the shift to high-deductible plans and the increase in non-premium cost-sharing are expected to stabilize. Makes sense – the economy is improving and employees are… [Read More]

Comparing Discounts in a Self-Insured Arrangement

Comparing Discounts in a Self-Insured Arrangement

In a self-insured plan, where 85% or more of cost is the actual payments made for medical claims, one of the most important factors to consider is the network; which one will provide the best access and which will yield the best provider discounts. Let’s start with access: which network most closely aligns with the providers your employees and… [Read More]