In Focus

News & Insight from Chelko Consulting
Are Benefits a Popularity Contest?

Are Benefits a Popularity Contest?

We recently wrapped up a series of roundtable meetings in various cities where we discussed results from an employer survey we conducted on Plan Design Considerations & Innovations. Attendees at each of the roundtables enjoyed spirited discussion of the survey findings in general and of specific plan management strategies. read more…

Seeing Clearly: The Cost of a Miracle Cure

Seeing Clearly: The Cost of a Miracle Cure

Preparing to pay for a new era of effective gene therapy

Could you imagine seeing stars in the night sky for the first time or even the site of your own parents’ faces after ten or even twenty years of significant visual impairment? The Food and Drug Advisory Committee heard personal testaments like these from patients explaining their miraculous results as part of two experimental gene therapy trials.

More than 25 years in the making, the FDA approved Luxturna® (voretigene neparvovec-rzyl), the first gene therapy for an inherited disorder involving a progressive form of blindness, typically starting in early childhood. Currently, no pharmaceutical alternative is available for these patients. read more…

Health Plan Sponsors Need Thaler Too!

Health Plan Sponsors Need Thaler Too!

Last week, Richard Thaler was awarded the Nobel Prize in economics for pointing out that individual behavior, with respect to investing for the future, is not rational. As someone said in a recent WSJ article on Thaler’s accomplishment, “We’re a nation of procrastinators, not a nation of portfolio managers.” read more…

Elephant in the Room: Are Employers Ready to Address Specialty Drug Spending?

Elephant in the Room: Are Employers Ready to Address Specialty Drug Spending?

Specialty drug costs continue to vex most health plan sponsors. This article from NEJM Catalyst brings to light some of the key issues and opportunities for employers. It highlights the Cleveland Clinic’s recent effort to eliminate $8.5 million of annual waste associated with two commonly used cardiovascular drugs. Employers have got to like that result! read more…

Managing Orphan Drugs in Your Health Plan

Managing Orphan Drugs in Your Health Plan

While the rapid evolution of modern medicine offers innovations in patient care, the resulting advancements are placing a fair amount of stress on our existing service delivery and payment models.

A prime example is orphan drugs — defined by the FDA as drugs and biologics for the safe and effective treatment, diagnosis or prevention of rare diseases/disorders that affect fewer than 200,000 people in the U.S., or that affect more than 200,000 persons but are not expected to recover the costs of developing and marketing a treatment drug. read more…

Keeping Score: Annual Claims per Employee

Keeping Score: Annual Claims per Employee

Knowing your organization’s number of annual claims per employee is an important piece in understanding its medical cost drivers.

When viewed in conjunction with cost per claim, you can quickly assess what is driving your per employee plan cost – is it usage/volume (more claims) or price/intensity (higher cost claims)? Once that’s determined, you can focus your management energies in the right place.

Let us know if you would like to learn more about how to improve your score in this area. read more…

CONTACT
Cleveland Office
24651 Center Ridge Rd, Suite 110
Westlake, Ohio 44145

Phone: 440.892.2600
Fax: 440.892.8920
Email: info@chelkogroup.com

Columbus Office
Phone: 614.869.4140

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