Chipping Away at the Affordable Care Act Isn’t Getting to the Real Issue

Health Care Reform sign

So, the Affordable Care Act’s (ACA’s) individual mandate penalty has been reduced to zero, the Cadillac Tax has been delayed for two more years (and may likely never be implemented) and the Children’s Health Insurance Program (CHIP) has been funded for six years. Now more than 1.75 million children in 20 states, who were at risk of losing their healthcare, can breathe… [Read More]

CVS-Aetna – a Few Weeks Later

Doctor sitting at table and working with tablet. Medical icons in hexagonals in front. Only hands seen. Concept of medical help.

So the CVS-Aetna deal has been seasoning a bit and I really haven’t heard of any major roadblocks to approval. And early integration planning is starting. Not that integration teams are that much of an indication as they didn’t portend a good result for the Aetna-Humana or Anthem-CIGNA mergers. It would seem that horizontal integration is… [Read More]

A Call to End Drug Rebates

Drug Cost  Specialty Pharmacy

Healthcare can be transformative and the ability to extend and improve life continues to rapidly roll in. But while medical advances are explosive, our creative skills in controlling costs proceed at a snail’s pace. I realize that change is hard, but it boggles my mind that we can’t take simple steps to reduce cost trends. Regulating drug… [Read More]

Donald J. Trump – To the Tune of “Alexander Hamilton”

ThinkstockPhotos-92369411crop

A common theme discussed in this blog this year has been remaking healthcare as we watch the twists and turns unfold in the legislative circus of healthcare reform. To close out 2017, we’ve put a musical spin on healthcare in America. SHARE THIS!

Are Drugs Cheaper Using Cash?

The concept of paid medicine with pills on a money background

This past weekend, a far-reaching exposé was published by the New York Times and ProPublica highlighting how, in many instances, individual members can save money paying cash when compared to using their insurance for their generic prescriptions. While this is not a new issue, the investigation reviewed the top one hundred prescribed medications, finding that 40% of the time… [Read More]

Stop Loss Insurance… More Important Than Ever

Stop Loss Insurance... More Important Than Ever

With the increase in popularity of self-insurance, health plan sponsors must take the time to fully understand the “safety net” that is typically purchased alongside these plans to protect them from unexpected costs. There are two elements of stop loss: Individual (or Specific) Stop Loss (ISL) protects against the costs of any one claimant exceeding… [Read More]

Good News – the Stop Loss Market Is Vibrant

Good News – the Stop Loss Market Is Vibrant

Uncertainty and frustration abound in the healthcare market today, especially with all of the brewing legislative changes and tension over the market’s response. On the employer-sponsored plan side of things the challenge to improve affordability goes on as well – but you can only make so many plan design changes to keep up. High deductible… [Read More]

Donald Trump is Coming to Town

donald-trump-is-coming-to-town

A musical and seasonal spin on U.S. healthcare and politics as we get ready to close out 2016. Set to the tune of Bing Crosby’s “Santa Claus is Coming to Town” SHARE THIS!

Politics and Healthcare

health policy

In the shadow of the failure of federally sponsored co-op: Health Republic, New York hospitals and other providers are lobbying hard for a healthcare guaranty fund to indemnify them against failures by other insurers. A common theme in this blog (see related posts here, here and here) is that the governmental role in healthcare should… [Read More]

More Bad News for the Individual Exchanges

healthcare exchange

In what came as no surprise to the insurance world, Aetna announced it is losing money in its individual exchange business. This comes on the heels of both UnitedHealthcare and Anthem Blue Cross announcing they had lost money in this segment. As we have chronicled in the past, the exchanges are enrolling fewer people than… [Read More]