Rebate Game on Overdrive

White Pills with a bottle and American Dollars

Every time I turn around there is another shell to watch in the game of rebate pricing. And just when you thought the pharmacy benefit manager (PBM) pricing structure couldn’t get more convoluted, it is… Most employers are already aware that PBMs provide significant rebates every time brand drugs are dispensed. As the cost of… [Read More]

Retiree Healthcare Back in Focus

A mixed race senior couple is kayaking down a river together. The image's focus is on the elderly woman smiling in the foreground. She is Pacific Islander and has graying hair. Her husband is seen in a kayak in the background. In the distance behind the couple you can see the shoreline and a bridge. The happy couple are wearing casual clothing. It is warm outside.

With the upturn in the economy, employers are again starting to look at improvements to benefit programs, especially for their key employees. Retiree healthcare is a topic where I am surprised that discussions have changed from “how do I eliminate this obligation” to “tell me what other employers are doing for their key staff for post-employment… [Read More]

“Right to Try” Is Compassionate Legislation, but Does It Make Sense?

research drug at science lab

President Trump signed the Right to Try Act yesterday, which cleared the House in late May, having been approved by the Senate in 2017. This legislation gives terminally ill patients the ability to access experimental drugs which have passed Phase 1 of the FDA approval process but are not yet officially approved. It is interesting to… [Read More]

Compliance Is Not Just Acronym Soup

Healthy Alphabet Soup in Tomato Sauce  Ready to Eat

ACA, ADA, GINA, HIPAA, EEOC, AARP, GDPR – the acronyms abound and these are just a few you need to be familiar with if you’re the wellness compliance guru at your company. I’ll limit today’s discussion to two of the more recent updates you should be aware of. General Data Protection Regulation (GDPR)­ Basically, the… [Read More]

Look to Automobile Insurance for Healthcare Answers

wrenches on garage wall, set of wrenches handy industrial tool,old wrenches in mechanic workshop,handy tool for motor vehicle mechanic use to fix motorcycle and car

We take care of our car. The oil, lights, brakes and steering are checked and in good shape, so we don’t expect anything mechanical to go wrong. Routine care costs are cheap and easy – besides, if the car is in bad shape the insurance company won’t cover it and it needs to pass a mechanical inspection… [Read More]

HSAs and Medicare – Like Oil and Water

Oil bubbles with water

I see more and more employers offering high deductible health plans (HDHPs) every year. This type of plan can be tricky, but it’s increasingly popular in the quest to keep premium spend down as healthcare costs rise. We come across our fair share of questions and issues with HDHPs and health savings accounts (HSAs) at… [Read More]

Trump Opts for a Baby Step in the Drug Cost War – Not the Expected Leap Forward

Also drug dealing, dealer or trade concept.

Last week President Trump released his long-awaited “American Patients First” blueprint on attacking out-of-control pharmacy costs. Unfortunately, it’s more of a whimper than a roar. If the regulations are effectively written to support my understanding of the President’s intent, the incremental steps forward were not horrible, they are just not bold enough. Drug manufacturers will have to… [Read More]

Why HR Should Care About User Experience

Portrait of a young adult male sat using his laptop in a modern office. Bangkok, Thailand. April 2017

You know that feeling – when you’re pulling your hair out over what should be a simple task on your computer or mobile device? It’s rare to go through the day without some kind of technological interaction, and when the tech doesn’t work or it’s not easy to navigate, we eventually wash our hands of… [Read More]

Politics and Healthcare – Nothing Is Easy

Pink cherry blossom and magnolia trees blooming at the White House in Washington, DC during the springtime

I had the pleasure of spending the day on Tuesday in Washington to discuss my favorite legislative topic – healthcare. First stop, the White House, where I met with the Special Assistant to the President for Health Policy. This was a lively discussion which covered rising drug prices, the opioid crisis, mental health parity and… [Read More]

Anthem’s Entry Signals Further Stop Loss Market Growth

Arrows up isolated, many different styles, illustration vector

The tectonic plates continue to shift underneath the health insurance market. Ten years ago, most medical carriers were predominantly “risk-bearing” entities – taking in premium dollars and in return, paying claims. But as those claim dollars rose and the Affordable Care Act (ACA) introduced additional fees to the insurance market more employers moved towards self-funding,… [Read More]