Participation: Is It a Good Thing or a Bad Thing?

prepare filling item form, business background

One of the central tenets of underwriting medical plans is to avoid adverse selection at all cost. Adverse selection results when a plan is designed or priced in such a way that it only adequately incentivizes sicker employees to enroll; failing to attract good risk to offset the bad. For this reason, most insurers historically… [Read More]

Start with Pharmacy to Reduce Healthcare Costs

Medical golden capsule full of coins isolated on white background

I was at dinner the other night discussing President Trump’s lashing out at insurance carriers and issuing an executive order to suspend federal funding for exchange cost-sharing subsidies (which last week I said was misguided). And my friend, a former insurance company executive, pointed out that since the Affordable Care Act’s passage, healthcare company profits and… [Read More]

Anthem Gets Tough with Hospitals

Anthem Gets Tough with Hospitals2

One of the greatest frustrations our self-funded (and to a lesser extent, fully-insured) clients voice is that – despite the hundreds of thousands or millions of dollars they pay the insurers to assist in managing their health plan spend – too often it appears the insurers are complicit in the rising healthcare spend by not… [Read More]

More Bad News for Obamacare


Last Thursday, for the first time, the U.S. Senate passed legislation to repeal the major provisions of the Affordable Care Act. The 52-47 vote marks the first time the Senate passed a stand-alone measure to repeal President Obama’s signature legislation. The House will need to approve the amended bill, which would eliminate the individual mandate… [Read More]

Interesting Facts You Probably Didn’t Know About HSAs

Healthcare Cost  Medical  Health Coverage

With each passing year, more employers are moving to high deductible health plans as the model of choice in managing healthcare spend. Not only are one third of large employers already offering them as the only option, even a major law firm client recently adopted the model in an effort to strategically combat healthcare inflation…. [Read More]

Healthcare Tradeoffs and Sovaldi: The Conversation We Must Have


A revolutionary new drug that treats Hepatitis C is igniting a critical debate at the heart of healthcare delivery. Sovaldi, the biotech drug, carries a price tag of nearly $100,000 for less than three months of treatment and has the industry in a panic: Patients demand it but insurers and the federal government fear they… [Read More]