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]

Getting Creative in Combating Rising Specialty Drug Costs

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High cost drugs are the most significant cost driver in healthcare today. Because of their therapeutic value (they cure illness), it is very difficult to manage the cost of these specialty medications. Prior approval, quantity limits and high cost-sharing have proven to be among the most effective utilization mechanisms. A study published in The Journal… [Read More]

What to Expect for 2018 Premium Increases

What to Expect for 2018 Premium Increases

UBS released its 2018 Large Employer Health Benefits Survey and the results are encouraging. Premium equivalents for this largely self-insured study group are expected to rise 6.1% on average from 2017. Interestingly, the shift to high-deductible plans and the increase in non-premium cost-sharing are expected to stabilize. Makes sense – the economy is improving and employees are… [Read More]

Repealing ACA… but What About the Replace?

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With the Congressional transition now complete, true to their word, Republican leadership is taking up the repeal of the Affordable Care Act as their initial agenda item. And the first hurdle has been cleared in a 51-48 Senate vote with Rand Paul the only senator to break ranks. Political jockeying is filling the airwaves with… [Read More]

Wikileaks Gives an Inside View of Clinton’s Healthcare Thinking

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Wikileaks recently exposed a Clinton campaign memorandum on the shortcomings in the Affordable Care Act. Well at least they understand that there are shortcomings. These include: Penalties that are insufficient to draw in young, healthy Americans Disappointing enrollment at less than half of the Obama administration’s projections primarily due to the lack of affordability for people earning… [Read More]

Healthcare Cost Pressures are Starting to Build

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Elected officials are starting to hear static about affordability (or lack thereof) of exchange plans. ACA cost-sharing is simply too high to provide meaningful protection for many middle to low income Americans. CMS put out a new marketing piece entitled: “Five Facts about Deductibles” to deflect the negative impression of deductibles which states: “Here are… [Read More]

Healthcare Realities Hit Harvard University

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You have to be pretty smart to understand healthcare. Ask the faculty at Harvard. They were generally strong advocates for the Affordable Care Act during the initial debate – after all, healthcare should be a right and not a privilege. We are a rich nation and progressive, means-based cost-sharing seems only fair. Wealthier Americans should… [Read More]