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]

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]

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]

Price Transparency: The Magic Bullet to Healthcare Cost Control

Price Transparency The Magic Bullet to healthcare cost control

More and more states are stepping into the pharmacy transparency issue. On June 2nd, Vermont passed compromise legislation requiring the drug makers of 15 of the most costly drugs to show cause for their high prices. And both Ohio and California (Massachusetts’ legislative effort was rebuffed) have pending bills that would require drug companies to reveal… [Read More]

Healthcare Costs Rise Above Projections

Healthcare Costs Rise Above Projections

I received an interesting email earlier this week from CareConnect, the new health insurer owned by the North Shore Hospital System. Apparently, New York State required rates 5% higher than CareConnect had requested. For the past two years, the New York regulators slashed requested rate increases, and then they were hit with a black eye… [Read More]

Reference-Based Pricing: A New Arrow in the Quiver

healthcare cost 3

In an effort to combat rising healthcare costs, self-insured employers have turned a new page. Under reference-based pricing models, the plan will reimburse costs up to a pre-set limit. Reference-based pricing works. A recent Reuters Health study shows that average costs for diagnostic testing were reduced by a third, as compared to more traditional reimbursement protocols. In this… [Read More]

Technology: The New Healthcare Frontier

Technology-The New Healthcare Frontier

A recent Harris Poll reports that nearly a third of Americans are uncomfortable with managing their healthcare. Healthcare costs for a family of four now exceed $25,000 per year, but Americans are less confident purchasing healthcare than buying a home or a car. And it is not easy to make good healthcare decisions. As a… [Read More]

Taxation Ahead – Limiting Health Premium Tax Deductibility


The big golden goose in paying for government’s healthcare costs is tax deductibility of health insurance premiums. The idea of limiting, or even eliminating, deductibility is often discussed because it solves a lot. However, when the fog clears, legislators realize that this will give an inducement to employers to head to the hills and discontinue… [Read More]