Wednesday, November 26, 2014

Narrow Networks…Healthcare Buyers Beware!

In the current, post Affordable Care Act (ACA) world, the term – narrow network is often heard, and at times, is a strategy deployed by employers and insurers. There are a variety of other ways to describe narrow networks, such as – carve out network; exclusive provider network; select network; tiered network…you get the idea. From a covered members standpoint, this strategy involves limiting the number of contracted providers plan members can seek care from, and in return, receive the best benefits, and lowest out of pocket costs. From the standpoint of the insurer or employer, narrow networks mitigate risk and reduce expenses.

Wednesday, November 5, 2014

The ACA and Newton’s 3rd Law of Motion

Sir Isaac Newton’s Third Law of Motion taught us that for every action, there is an equal and opposite reaction. As we near the end of the fourth full year of the [partial] roll out of The Affordable Care Act /Obamacare, it has become increasingly more challenging for people to differentiate action from the equal and opposite reaction. Put another way, some of the things we’re experiencing, required by the ACA, are directly attributable to the law itself (call these actions). And then there are things we’re seeing that are the result of the many requirements, mandates, fees/taxes, expansions associated with the ACA (call these equal and opposite reactions). This will all make more sense when you see the chart at the end of this article.