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]

Zombie Apocalypse: Health Insurer’s Tax

Zombie Apocalypse Health Insurers Tax

In 2014, fully-insured employer plans were greeted with a nasty surprise – the Health Insurance Providers Fee. The insured’s already massive healthcare costs were being further inflated 1.5–2% due to the new tax congress levied on insurers, which was based upon each carrier’s market share in the health insurance market. Of course that $8 billion… [Read More]

Watch Out for the Unintended Consequences of Washington Shenanigans


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]

And You Thought There Was Nothing New in Healthcare? Shifting from “Volume” to “Value”

And You Thought There Was Nothing New in Healthcare

High deductible plans are running their course. Wellness, while useful, isn’t delivering immediate savings. Many of our clients are wondering what “the next big thing” is in healthcare delivery. Alongside the rising trend of healthcare consumerism, Accountable Care Organizations and the buzz of private exchanges stormed into the healthcare delivery conversation. We’re now starting to… [Read More]

Future is Now: Healthcare Delivery Systems

Future is Now Healthcare Delivery Systems

Two years ago I was out to lunch with a well-regarded industry colleague and I asked him his thoughts on the next cost mitigation “silver bullet” for employers who had already adopted high deductible plans. His answer was provider-directed initiatives like bundled payments and value-based contracting. That future is now here and innovators in the… [Read More]

The Battle for Repeal and Replace Has Begun

The Battle for Repeal and Replace Has Begun

Like it or not President Trump continues to follow through on the policies and provisions he espoused during his campaign. On Thursday, the Republican blueprint for healthcare was released and in the coming weeks this document will be organized into a plan to repeal and replace Obamacare. Central to the document is the elimination of… [Read More]

Insurers, Not Government, Will Lead the Way to Lower Healthcare Costs

Insurers, Not Government, Will Lead the Way to Lower Healthcare Costs

Sitting in a regional meeting for Aetna gives me time to reflect on bigger thoughts about how to tackle healthcare in the United States… In seeking solutions to the healthcare crisis, politicians have a different focus than insurers. Access is the politician’s biggest concern – how to address the needs of the greatest number of… [Read More]

Fighting Pharmacy Inflation

Fighting Pharmacy Inflation

There is an inherent battle between employers and their pharmacy benefit managers. Simply put, PBMs get paid on the volume of drugs dispensed and have little incentive to control utilization of expensive medication. Even worse, drug rebate allocations skew incentives even more when PBMs or health plans use rebate sharing to enhance profits. Consider this:… [Read More]

Justice Department Finally Turns Attention to 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]