Association Health Plans – Will They Help?

Association Health Plans – Will They Help?

The Trump Administration has released its final rule on Association Health Plans (AHPs). This has been a long-debated topic. Advocates feel that groups in the same trade, industry, line of business or profession – or those that exist within the boundaries of the same state or metropolitan region – should be able to band together to have… [Read More]

Is More ACA Confusion Possible? You Bet.

As if the ACA debate couldn’t get more complex – the U.S. Department of Justice (DOJ) has declined to defend an ACA challenge filed by Texas and several other Republican states, seeking to invalidate the pre-existing coverage mandate – and therefore the entire law.  The suit alleges that since the individual mandate was reduced to… [Read More]

Trump Opts for a Baby Step in the Drug Cost War – Not the Expected Leap Forward

Last week President Trump released his long-awaited “American Patients First” blueprint on attacking out-of-control pharmacy costs. Unfortunately, it’s more of a whimper than a roar. If the regulations are effectively written to support my understanding of the President’s intent, the incremental steps forward were not horrible, they are just not bold enough. Drug manufacturers will have to… [Read More]

Politics and Healthcare – Nothing Is Easy

I had the pleasure of spending the day on Tuesday in Washington to discuss my favorite legislative topic – healthcare. First stop, the White House, where I met with the Special Assistant to the President for Health Policy. This was a lively discussion which covered rising drug prices, the opioid crisis, mental health parity and… [Read More]

Warning – The Healthcare Status Quo Is at Risk

Whether the Affordable Care Act (ACA) was ever an effective way to combat the issues facing our healthcare system is arguable – but it is clear that our political process has not helped. The Commonwealth Fund recently reported that the uninsured rate for working-aged Americans (between 19 and 64) has increased from 12.7% in 2016 to… [Read More]

Small Group Savior? Another Look at QSEHRAs

Magnifying glass looking at health care newspaper headline, on cash

Small employers are often looking for ways to break out of the community rated market and lower their health insurance costs, as I’ve witnessed firsthand and written about over the years. In more recent posts we’ve discussed reference-based pricing, PEOs and self-funding as methods small employers can use to potentially gain access to more favorable plan designs and rates. There’s… [Read More]

Preventive Care that Actually Saves Money… Dental

Toothbrush and toothpaste in the bathroom close up.

Over the last two decades, the healthcare industry has tied itself in knots in order to validate the business case behind preventive medical care. And although preventive care services offer a variety of benefits – social and humanitarian, for example – the data seems almost conclusive that economics is not quite one of them. Too… [Read More]

Healthcare Has Been Screaming for a Disruptor

businessman screaming news, or adult who asks a job - communication

Someone heard. Rumors have been swirling that Amazon, the market status quo killer, was setting its sights on healthcare – one of the least transparent and most inefficient markets – which accounts for almost 20% of U.S. Gross Domestic Product (GDP). Today Amazon joined with market-savvy Berkshire Hathaway and JPMorgan Chase to announce that a new… [Read More]

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]

A Look at 2018 Healthcare Issues

Illustration of 2018 greeting for new year celebration with heartbeat design

Price Waterhouse’s Health Research Institute released their 2018 Top Health Industry Issues report. 2017 was quite a year for healthcare as the industry tried to address controlling healthcare costs in light of the failure of legislative reform along with natural disasters, opioid abuse and cyber security – and all of those issues continue. With the inability… [Read More]