Will the Urge to Merge Help Healthcare?

Businessmen connect puzzle lamp. Joint efforts, success, union, idea. Vector illustration Eps 10 file. Success Cooperation

The announcement this week that CVS would be acquiring Aetna is the latest effort to remake U.S. healthcare. Costs are still spiraling upwards at an unsustainable rate and try as we can, inertia makes efficiency and cost reduction battles difficult to win. “Bigger” hasn’t done much to reduce costs. The health insurance market is down to… [Read More]

In Healthcare, the Art of the Deal is Not So Artful

In Healthcare, the Art of the Deal is Not So Artful

The Washington shenanigans continue as President Trump holds out the specter of supporting the bipartisan Alexander-Murray Senate bill which attempts to shore up the Affordable Care Act and set up a reinsurance fund for large claims. The president has also promised to back off his threat to cut off funding of cost-sharing subsidies. All this… [Read More]

Facility Fees: An Alarming Billing Trend That May Cost You

Facility Fees - An Alarming Billing Trend That May Cost You

Get this – an employee decides to see an in-network doctor for a medical issue. At the end of the visit, they pay the applicable office visit copayment. All good? No. Facility fees charged by hospital-owned clinics are a new wrinkle in the reimbursement battle. In addition to the charge for the doctor’s services, patients are… [Read More]

What Repeal of the Individual Mandate Would Mean to Americans

ThinkstockPhotos-122516159

The Republicans are at it again. The latest negotiations in the Senate on their tax bill have led them back to a proposal to eliminate the individual mandate under the Affordable Care Act. The lure of more than $300 billion in tax savings as calculated by the nonpartisan Congressional Budget Office (CBO) is too big a number… [Read More]

Why Employers Should Practice Medicine

Assorted Medical Insignias Logotypes Template Set. Line Art Vector Elements.

Every businessperson will tell you that the key to reducing costs in any industry vertical is by reducing the amount of friction in the transaction. Friction is created every time an additional party is brought to the transaction because that party will likely have its own profit incentive, thereby increasing the cost of the product… [Read More]

ACA Penalties Are About to Hit Employers

ACA Penalties Are About to Hit Employers

Reach way back into your memory bank to the time when your broker presented you with a “pay or play” analysis to determine whether you comply with the employer mandate under the Affordable Care Act. There was the $2,000 penalty which applies to every full-time employee in the event there was no valid offer of… [Read More]

Reference-Based Pricing – Not Just for Large Groups Anymore

Reference-Based Pricing – Not Just for Large Groups Anymore

“It’s not health insurance that’s expensive; it’s the cost of healthcare,” a keen observation from a recent blog post by Frenkel Benefits’ president, Craig Hasday. It’s safe to reason that anything which lowers the cost of healthcare should lower premium rates – but is it that easy to get done? Employers try to mitigate healthcare costs in… [Read More]

Healthcare is a Three-Ring Circus

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Open enrollment has started for the 1/1/2018 policy year and anyone faced with a purchase decision is surely confused. On the off chance that any of those prospective healthcare exchange customers are following this blog I thought I would take this opportunity at the start of the shortened open enrollment period to clarify the rules:… [Read More]

Start with Pharmacy to Reduce Healthcare Costs

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I was at dinner the other night discussing President Trump’s lashing out at insurance carriers and issuing an executive order to suspend federal funding for exchange cost-sharing subsidies (which last week I said was misguided). And my friend, a former insurance company executive, pointed out that since the Affordable Care Act’s passage, healthcare company profits and… [Read More]

Healthcare Reform – Finally a Movement Toward Bipartisan Cooperation

Are Association Health Plans a Good Idea

The nine million Americans covered by the federal healthcare exchanges must be feeling a lot like a ping pong ball… It’s a good thing the ball is moving so fast they can’t see it. President Trump has reversed himself again and indicated that he would not support a bipartisan effort to plug some of the holes… [Read More]