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Friday, July 24, 2020

Telehealth Use On the Rise!

Telehealth*, which is sometimes referred to as Tele-medicine, Virtual-Health, Tele-Doc, etc., has grown to become a reliable source of healthcare, particularly during the current Covid-19 pandemic.  The virtually immediate, 24/7/365 access to healthcare is appealing to a variety of stakeholders, chief among them those that live in remote or rural areas.  A recent source found the use of telehealth increased an impressive 4,347%, or from .17% of claim types to 7.52%, during the period from 3/2019 to 3/2020.    

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Wednesday, April 15, 2020

Coronavirus Pandemic Impact On Health Spending Accounts

In light of the Coronavirus pandemic, Congress, the Office of Personnel Management (OPM),  and the IRS have made key changes affecting the use of tax-free funds that reside in tax preferred spending accounts:

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Tuesday, April 7, 2020

Health Ins. Options During Coronavirus Pandemic

The COVID-19 pandemic has disrupted and changed the health insurance landscape for many people.  Here’s a review of the various options available to people, depending on their specific situation and eligibility:

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Monday, March 30, 2020

CARES Act Impact on Health Insurance

On March 27, 2020,  the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) became law.  The CARES Act amends certain provisions of the Families First Coronavirus Response Act (“FFCRA”).  CARES also temporarily eliminates deductibles for certain services in HSA Qualified High Deductible Health Plans (HDHPs), and temporarily expands the list of qualified expenses reimbursable through HSAs, HRAs, and FSAs.

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Wednesday, March 25, 2020

Families First Coronavirus Response Act

On March 18, 2020 the President signed into law the Families First Coronavirus Response Act (FFCRA), which takes effect April 2, 2020.  The FFCRA includes several provisions that impact employers with less than 500 employees, with allowable exemptions for affected employers with fewer than 50 employees.  This blog post addresses the three (3) main aspects of the FFCRA: 1. Mandated waiver of health insurance related cost sharing for COVID-19 testing; 2. New paid leave entitlements;  and 3. Employer tax credits.  

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Wednesday, March 11, 2020

Coronavirus Health Insurance Benefits

Leaders of the major health insurance companies in the U.S. agreed to expand insurance benefits related to Corornavirus/COVID-19, in a historical meeting held at the White House yesterday (March 10, 2020).  Present at the meeting were executives from: Aetna
Blue Cross Blue Shield (BCBS) Association (representing the 36 BCBS plans throughout the nation, including Anthem)
Cigna
Humana
UnitedHealth Group (aka United Healthcare)

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Tuesday, October 1, 2019

Top 10 Non-Insurance Healthcare Payment Options

Stop the (healthcare) madness!  I often lecture (both when asked and not) about one of the most defective, yet easily correctable parts of our healthcare system.  That is…our penchant for insuring risks that are neither catastrophic nor unexpected in cost or aspect.  The administrative costs associated with processing lower cost healthcare claims slows down the system, and inflates already high premium costs

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Thursday, May 9, 2019

Accountable Care…The Savior of U.S. Healthcare?

Since the passage of the Affordable Care Act (ACA) in March of 2010, much has been discussed, debated, written, and deployed relative to healthcare FINANCING reforms (see insurance, Medicare, Medicaid, self-insured employers, fees/taxes, pre-existing conditions, essential health benefits, community rating, minimum loss ratio, etc.).  But very little has been written, or even revealed for that matter, about the ACA’s healthcare DELIVERY reforms and incentives.  This is too bad, since we know that $.80 to $.85 of every dollar of billed health insurance premium is directly related to healthcare delivery.  So it stands to reason that if we could reduce health CARE costs, health insurance PREMIUMS would follow suit.  Enter Accountable Care Organizations (ACO) into the equation.  Let’s examine what ACO’s are…who they are…and why many are looking to them to save America’s healthcare system from imploding.

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Tuesday, April 16, 2019

Prescription Drug Spending Trends

As employers, patients, and other stakeholders continue to struggle with the rising cost of healthcare (and health insurance!), one particular component of overall healthcare spending seems to be occupying the majority of attention – prescription drugs!  In 2019, the U.S. is projected to spend $500 billion on prescription drugs alone, which marks a 12x increase from less than 20 years ago!*  A number of factors are at play in the cost pressures affecting drugs, on both the supply and demand side.   Much is being discussed and debated on the topic of addressing skyrocketing drug prices, including government intervention on a number of fronts.  Needless to say, we are closely monitoring developments in the area of prescription drug trends.  So here is the first of likely several posts addressing some of the more pressing matters affecting prescription drug use and spending. 

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Thursday, July 12, 2018

Reference Based Pricing

Among the strategies being deployed by benefits brokers/consultants, on behalf of employers feeling squeezed by ever increasing health insurance costs is REFERENCE – BASED PRICING (RBP).  Variances in the price of healthcare can be as much (or even more) as 500% for the same services…with little to no difference in quality.  Don’t believe me?  See forLEARN MORE