Insurers, Providers and Employers on a Collision Course 

Insurers, Providers and Employers on a Collision Course 

Trying to control healthcare costs is like trying to pick up Jell-O pudding with a pair of chop sticks. It is virtually impossible. The employer-based healthcare system relies on their intermediaries – primarily the large national insurers – to negotiate discounts, provide claims-paying acumen, fraud oversight and clinical expertise, among other things, in the administration of… [Read More]

Cost-Control Over Risk: More Employers Embrace Self-Insurance

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More and more employers are embracing self-insurance; according to the U.S. Department of Health & Human Services, more than 80% of companies with 500 or more employees have self-insured plans. That’s astounding in the context of historic statistics which showed that only the largest employers used this funding mechanism. And since new products from traditional… [Read More]

Is Healthcare Realigning the Deck Chairs on the Titanic?

Is Healthcare Realigning the Deck Chairs on the Titanic?

It has been widely rumored that the Kentucky based insurer, Humana, is ripe for a transaction. Fueling the speculation is Humana’s poor performance of their public exchange products, suppressing profitability in the past year. Coupled with their significant Medicare Advantage members, they become an attractive target for the remaining national players. Anthem would be the most… [Read More]

Reshaping Healthcare in the United States

Reshaping Healthcare in the United States

I used to think that the U.K. healthcare system is one of the best in the world.  A mix of public healthcare for all citizens, with a private option for those that can afford it. This week, while on vacation, I spent some time with two recently retired doctors who had worked for the U.K…. [Read More]

Doc Fix – Is it Finally Fixed?

Doc Fix – Is it Finally Fixed

Price controls don’t work to control cost inflation. Politicians are not the most steadfast policymakers; over time, changing and re-changing direction. Nowhere have these two truisms been more evident than in the debate surrounding the Medicare sustainable growth rate (SGR) formula. In 1997, Congress imposed a formulaic price control to reign in the escalating budget… [Read More]

Should the U.S. Consider Single-Payer?

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I try to be open-minded and explore other viewpoints even if they are far afield of my thinking. So last week, when Albany politicians passionately made the single-payer argument, I took a step back. Does single-payer make sense or am I just fighting it because it would significantly impact my revenue? I have been mulling… [Read More]

Healthcare Trends–Leveraging Benefits Down

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Spiraling costs make our healthcare system very fragile. Employers remain committed to providing healthcare benefits, but they are looking for solutions. The New York Times reported this week that almost one third of large employers will be offering high deductible plans as a single plan option in the coming open enrollment. This is up from… [Read More]

Strategic and Honest Communication: AOL Provides a Cautionary Tale

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Tim Armstrong, AOL’s CEO, is not having a good month. But thanks to AOL, we have a cautionary tale on the value of strategically and honestly communicating with employees. Now, more than ever, employers find themselves in the difficult situation of cutting or changing employee benefits – just as AOL recently did when they made… [Read More]