Can the cost of a hip replacement in Philadelphia really vary from $11,000 to $125,000? From white papers to published books, much has been written about how difficult it can be to find out what a hospital stay or outpatient procedure will cost. And as Anna Wilde Mathews observed in her article Lifting the Veil [...]
Over the past several months, the Trump administration has introduced several ideas intended to fight skyrocketing prescription drug prices – everything from forcing manufacturers to display prices in their television commercials to having Medicare base payments for costly drugs on average prices in other industrialized nations, which are much lower than in the U.S. While [...]
A little skin in the game can make a big difference. At our recent “Let’s Take Control” themed Solutions Day, Adam Russo of the Phia Group shared his story that earned front page coverage in the Boston Globe. He told the audience about a tactic Diversified Group has helped many employer groups implement over the [...]
Controlling Health Plan Costs Is Everyone's Responsibility Recent trade publication articles have featured tales of large carriers offering bonuses and quarterly incentives to advisors who agree to move their clients from a self-funded health plan to fully-insured. After managing self-funded health plans for more than 50 years, we’ve seen just about every scheme you can [...]
You Can't Manage What You Don't Measure! With a self-funded healthcare plan and a good, independent TPA, access to claims data is standard operating procedure. Even more important, a good TPA like Diversified Group has the expertise to convert your data into intelligent, actionable strategies to manage your plan, monitor performance and modify plan design [...]
From a drug manufacturer that contributes money to a non-profit Copay Assistance foundation and then steers Medicare patients taking their drugs to that foundation to a diagnostic lab that pays doctors for every blood test they refer, disguising the payments as “processing and handling fees”, there seems to be no end to the costly schemes [...]
With More Families Forced to Choose Between Healthcare & Housing, It May Be the Future As a TPA, employer groups count on us to make their health benefits work. While that sounds easy enough, it can be anything but easy when ordinary working families face hospital bills they can’t handle. One couple recently found themselves [...]
It Could Be Your Path to Value and Transparency! Direct financial relationships between individuals or employers and primary care physicians are gaining in popularity – and for good reason. In contrast to the traditional fee-for-service payment arrangement, where physicians are reimbursed according to the volume of services they provide, direct primary care (DPC) shifts the [...]
If It Helps to Control Costs...We Say Have At It! While many healthcare providers and insurance carriers are raising concerns about the recently announced partnership by these mega employers, I say Thank You! That's right – thank you for caring enough about runaway healthcare costs to do something disruptive. For making a commitment to get [...]
