In Focus

News & Insight from Chelko Consulting
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…

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…

Keeping Score: What’s Your Rx Spend PMPY?

Keeping Score: What’s Your Rx Spend PMPY?

Prescription drugs can be difficult to manage in a plan, especially if you don’t have a good grasp of all the related metrics.

  • Do you know what you’re spending on every member in a year?
  • How do your Rx numbers compare to our database?
  • Do you know what’s causing the changes in your drug costs year-to-year?

There are several strategies and tools employers can deploy to mitigate rising prescription drug costs. But first you need to track these numbers to get at the root cause.

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

Survey Reveals Employer Attitudes Regarding Private Exchanges

Survey Reveals Employer Attitudes Regarding Private Exchanges

The 5th Annual Employer Survey on Private Exchanges indicates exchanges appear to be gaining some traction with post-65 retiree groups, but aren’t driving change when it comes to active employees.

Conducted by the Chelko Consulting Group, in cooperation with the Worldwide Employee Benefits Network (WEB), the annual survey tracks employer attitudes pertaining to the viability of private exchanges as a healthcare coverage strategy for active and retired employee groups. read more…

An Epidemic of Unnecessary Treatment

An Epidemic of Unnecessary Treatment

We wanted to share an article from The Atlantic by David Epstein that deeply resonated with us. It is long, but we encourage you to take the time to read it, and share it with others you care about. The piece does a great job of encapsulating a number of our longtime concerns as healthcare consumers and consultants regarding unwarranted, and sometimes even harmful, treatments that are commonly provided to our plan members. read more…

Keeping Score: Know Your Net Cost

Keeping Score: Know Your Net Cost

Most employers benchmark their gross health plan cost on a per employee per year basis. The net amount employers pay (gross health plan costs minus employee payroll contributions) is also an important measure to track in support of sound plan management. As you can see, the amount can vary from one employer to another by thousands of dollars per employee.

Where do you fall in the range above? Knowing how that number matches up against your budget, benchmark, and last year should be a priority. It goes without saying that having answers to questions like this at your fingertips enables you to better manage your plan.

Let us know if you would like to learn more about answering this question, tracking your numbers, and better managing your plan.
read more…

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