Is Reference Based Pricing Saving Money?


When the independent think tank finds that on average, prices paid to hospitals by younger, healthier policyholders were 100 percent higher than what Medicare would have paid for the same procedures, it’s easy to understand the impact that payment contracts based on what Medicare pays can have on health plan costs. In contrast to traditional [...]

Is Reference Based Pricing Saving Money?2021-01-14T17:28:22+00:00

Orders to Cut Drug Costs


In an effort to revive an important promise made to the American people prior to his election in 2016, President Trump recently signed 3 executive orders aimed at bringing the cost of prescription drugs more in line with what consumers in other countries pay. One order, directed at Medicare Part D plans, would require that [...]

Orders to Cut Drug Costs2021-01-07T15:53:58+00:00

Final Transparency Rule for Health Plans and Insurers


On October 29, 2020, the Departments of Health and Human Services (HHS), Treasury, and Labor issued the “transparency in coverage” final rule. This rule imposes new requirements on group health plans to disclose cost-sharing estimates at the request of an enrollee and publicly release negotiated rates for in-network providers, historical out of network allowed amounts [...]

Final Transparency Rule for Health Plans and Insurers2020-11-23T17:12:23+00:00

How Much Do You Know About Costs?


In 2017, according to the Centers for Medicare and Medicaid Services, healthcare spending for every man, woman and child in the U.S. totaled nearly $11,000 – more than any other wealthy country. The interesting thing is that very few of us really know what goes into this number or who pays the bills. Here are [...]

How Much Do You Know About Costs?2020-11-12T15:44:10+00:00

Price Transparency Efforts Continue


In a recent decision by the U.S. District Court for the District of Columbia, the AHA lost its bid to avoid having to disclose rates hospitals negotiate with insurers. While an appeal is expected, this is a win for the administration, which is committed to providing patients with understandable information about the cost of medical [...]

Price Transparency Efforts Continue2020-11-05T15:27:02+00:00

HSA Limits Increase for 2021


Inflation-adjusted limits for contributions to health savings accounts and high deductible health plans for the coming year were just announced. According to the announcement, eligible individuals with self-only HDHP coverage will be able to contribute $3,600 to their HSA in 2021, an increase of $50 from 2020. Those with family coverage will be able to [...]

HSA Limits Increase for 20212020-10-29T14:21:46+00:00

Calls for Expanded COBRA Coverage


With nearly 40 million workers laid off or furloughed as a result of the Coronavirus, many organizations have urged Congress to expand COBRA coverage. Most of their concerns are focused on encouraging Congress to subsidize COBRA premiums for these workers so that existing health conditions will not get worse because care is delayed. To date, [...]

Calls for Expanded COBRA Coverage2020-10-23T14:26:56+00:00

How a Premium Dollar Is Spent


America’s Health Insurance Plans, a national trade association whose member companies provide insurance coverage and health-related services to consumers and businesses, has released a study revealing the breakdown of today’s healthcare premium dollar, as follows: 23.3 cents of every premium dollar is used for prescription drugs 22.2 cents cover the cost of physician services 20.2 [...]

How a Premium Dollar Is Spent2020-10-08T14:34:06+00:00

HRAs and Direct Primary Care


A recent IRS proposal would enable workers to use ordinary health reimbursement arrangements (HRAs) to pay for direct primary care program memberships. In addition to giving workers the peace of mind in knowing they can fix the costs of primary care, the proposal would help primary care doctors reduce the time and money they spend [...]

HRAs and Direct Primary Care2020-09-03T15:10:58+00:00

FMLA Expansion Under Coronavirus Response Act


When President Trump signed the Families First Coronavirus Response Act into law in mid-March, employers with fewer than 500 employees became responsible for providing paid leave to certain employees through Dec. 31, 2020. The benefit extends to employees unable to work or telework due to the need for leave to care for a son or [...]

FMLA Expansion Under Coronavirus Response Act2020-07-02T13:42:06+00:00