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]

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]

Watch Out for the Unintended Consequences of Washington Shenanigans

can-we-stop-obamacare-meltdown

Once again President Trump is threatening to drop the Obama administration’s appeal of the Federal Circuit Court ruling that would disallow funding for cost-sharing subsidies for low-income Americans. These subsidies amount to about $7 billion a year and would affect about 7 million members who obtained coverage on the individual market. As a result, this is… [Read More]

Is the AHCA Shifting the Deck Chairs on the Titanic?

Is Trumpcare Shifting the Deck Chairs on the Titanic

The healthcare news wires are ablaze this week with the introduction of Republican bill to repeal the Affordable Care Act. Led by Speaker Paul Ryan, he pledged that the bill would “drive down costs, encourage competition and give every American access to quality, affordable health insurance.” As a budget reconciliation bill, only items impacting revenue… [Read More]

Justice Department Finally Turns Attention to Pharmacy Collusion

justice-dept-pharmacy-collusion

One of the biggest frustrations echoing from our postings over the last couple of years has been the covert, if not outright overt, collusion in the pharmacy market between drug manufacturers and in many instances the PBMs—pushing up the list cost of pharmaceuticals. This has been an issue hitting our clients’ wallets hard because although… [Read More]

Millennials are the Key to Healthcare

iphone  millennial communications

When I became an “adult”, one of the first things I thought about was healthcare. That was the way you did things. But today’s new “adults” aren’t wired that way. Healthcare just isn’t top of mind to millennials. They don’t understand it and they don’t think they need it. They don’t want to go to… [Read More]

Pharmacy Cost Confusion

Pharmacy Cost Confusion

What is going on with the pharmaceutical industry? Sometimes I feel like they are taunting all of us. I have been writing about the abuses the industry has been imposing on our healthcare system (see related posts here, here and here). There is a lot of subterfuge and non-transparency surrounding costs and the vultures are circling. Pharmacy Benefit… [Read More]

McKinsey Study Is the Latest Evidence That Obamacare Is Not Working

Obamacare

After years of politically biased pontification, likely created by the effects of the ACA, the last few weeks have been littered with actual data-driven evidence on performance. And the news has not been good – that is, depending on your definition of success. Some industry experts seem to have very mixed measures of success that… [Read More]

It’s Time to Get Real About Medical Insurance Costs

healthcare cost medical insurance

Intuit, the tax preparation software company, has said that three-fourths of filers who might be subject to the individual mandate were able to find an exemption in 2015.  It’s no surprise with the liberal policies put in place by regulators that this watered down threat provides little leverage to bring the healthiest Americans into the… [Read More]

Is Consumerism a Field of Dreams?

healthcare cost2

The ACA Times, an online industry publication, recently reported on a JAMA Internal Medicine research survey of factors considered when choosing physicians. Significantly, only 10% of respondents considered changing doctors and only 4% considered cost comparisons when making their choice. This was the case whether the plan was a traditional plan or a high deductible… [Read More]