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]

It’s a Legislative Circus Out There

It’s a Legislative Circus Out There

My predictive skills have been working pretty well on healthcare reform. I suggested that it wouldn’t be easy or quick. I thought the House would fall in line and the Senate would eke something out – and that it ultimately will come to a thumbs up / thumbs down in both houses of Congress. With… [Read More]

Healthcare. Okay. Now What Do We Do?

Flag and Stethoscope

What a week it’s been. I am not sure why President Trump thinks that his latest attempt to coerce the Republican Congress will work better than his past efforts. The Democrats relied on 50 votes to get the Affordable Care Act (ACA) through and now the Republicans are trying to rely on 50 votes to make… [Read More]

What Will Trumpcare Mean for Employers?


Post-election, I have met with dozens of employers and the number one question on their mind is: what will the new administration do to our healthcare strategy and what steps do I take to correctly position my employee benefit program? The short answer is to stay the course. Except for those employers offering Minimum Essential… [Read More]

Bill Clinton Thinks the Affordable Care Act Is ‘The craziest thing in the world’


Bill Clinton seems to agree with me – we should’ve just expanded Medicaid and been done with it. He said that the system does not work for the middle class who make too much money to get government assistance but still have trouble affording high premiums. But he wants to take Medicaid a step further…. [Read More]

This Chart May Be the Laws Unraveling


After seven years of partisan bickering, arguments, and counterarguments about the ACA’s successes (dramatically reducing the uninsured rate) and failures (lack of competitiveness, high costs), there is one chart that holds the greatest influence over the future of the ACA. The chart has been published by the polling firm, Gallup, over the last five years,… [Read More]

Golden Years for Retiree Benefits

Golden Years for Retiree Benefits

It’s been two decades since employers began eliminating retiree healthcare benefits en masse. But new developments are causing the cresting of another wave out of the retiree ocean. In the mid 90s, as a response to newly published accounting standards (FASB 106) – which required employers to recognize the present value liability of future retiree… [Read More]

Presidential Healthcare Politics

Handicapping Healthcare Election #2

The reason we haven’t heard much about healthcare during this highly charged election year is that the candidates aren’t too far apart. Clinton is supportive of continuing the Obama ACA legacy with small adjustments, and Trump, although asserting repeal and replace, seems to be taking a similar approach: building on the changes made to healthcare under… [Read More]

Medicare: Helping Change the Way Healthcare is Delivered

healthcare medicare cost

Recently, CMS announced that it is beginning a pilot program for a new payment model for primary care Medicare doctors. The government is going to lead the way in the shift from pay-for-services to pay-for-performance with a five year pilot which will include 20,000 physicians and 25 million patients. Under the voluntary program, physicians who… [Read More]

New Payment Protocols Will Lead to More Confusion

ICD-10  Insurance Claim Form  Healthcare Paperwork

As of October 1, ICD-10 has come to a medical provider office near you. International Classification of Diseases (ICD) codes identify a patient’s conditions, diagnoses and treatments. As our healthcare payment system switches to performance-based protocols, expansion of the ICD-9 codes has become essential. Additionally, doctor chart notes – which have been used for more… [Read More]