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]

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]

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]

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]

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]

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]

Is Government-Provided Healthcare Better?

Cuban Healthcare Reform pic

I recently returned from a cultural excursion to Havana, Cuba. As a healthcare geek, of course I wanted to know about accessing care in a communist country. First, I must say that I was surprised to find that the country did not live up to the third world impressions which many people may expect –… [Read More]

Controlling Specialty Drug Spending

Drug Cost  Specialty Pharmacy

Another commentary from the National Blue Cross Consortium. As I mentioned in prior posts, large claims are on the rise. Last year, Blue Cross paid their first individual claim for more than $15M, and the frequency of claims over $1M tripled from 2010 to 2015. Specialty medications are a real focus area. There is a… [Read More]

New York’s Surprise Healthcare Bill Will Be a Surprise to Taxpayers

Money coming out of jar

New York’s “Emergency Medical Services and Surprise Bills” law is in effect as of March 31. This should be good news to consumers who might be billed for out-of-network services when care is rendered by a doctor outside the network without the patient’s knowledge or consent. The law also permits consumers to seek care from… [Read More]