In response to President Trump’s June 24, 2019, executive order, the Centers for Medicare & Medicaid Services developed proposed rules that mandate “consumer-friendly” price transparency for hospitals.
Starting January 1 of 2020, hospitals will have to publish price information organized in a standardized way so patients will be able to do an accurate comparison of procedure pricing between hospitals. Hospitals will also be required to post all their payers specific negotiated rates, which are the prices actually paid by insurers, in that same format.
The Trump administration says the rules will increase competition among hospitals and lower healthcare costs for consumers. The CEO of America’s Health Insurance Plans claims, “Publicly disclosing competitively negotiated, proprietary rates will push prices and premiums higher — not lower.”
A recent survey from the Chelko Consulting Group and Worldwide Employee Benefits Network was conducted to gauge employee benefit professionals’ opinions on the potential impact of these rules. Respondents represented employer plan sponsors, benefits advisors, and insurance companies. (more…)
An estimated 96 percent of large employers offer telemedicine services to their employees. While independent services like Teladoc have been around for more than a decade, now most insurance providers offer their own telemedicine programs as an add-on service to employers.
Health plan sponsors have added these programs to combat the rising cost of emergency room and urgent care services. However, as employer adoption of telemedicine grows, it hasn’t become any easier to determine if the goal of reducing cost is being achieved. In fact, some research shows that telemedicine may actually be increasing health plan costs. (more…)
Hold your questions until the end, please.
You know what we can’t stand about a text message announcement? You cannot respond with a question. The same goes for an email. Sometimes the info is timely and useful, but what if you have a follow-up question or require a point of clarification?
Those forms of communication may work well for quick reminders (think “Don’t forget to enroll” or “Three more days until open enrollment closes”), but what about the big stuff? We’re talking more complicated or nuanced items like changes in cost sharing, a new type of plan, or updated eligibility rules. (more…)
This year marked our fourth annual Deep Dive Roundtable where leading employers from across Ohio gathered in Columbus to discuss plan management strategies and review benchmarking information on how their plan metrics stacked up against peers’. The fourth iteration of the gathering also featured two special guests who added fresh layers of insight and perspective to the day. (more…)
Vendor Reviews & Recommendations was the topic for a recent series of benefit roundtables our firm hosted for leading employers in several cities. It was a great opportunity to share and compare insights on a variety of benefit vendors.
One of the most intriguing conversation threads in each location involved medical plan administrators. As the clear majority of groups contracted directly with an insurance carrier (UHC, Anthem, MMO, Aetna, Cigna, etc.), we expected some standard vendor comparisons with associated pros and cons. However, what emerged was an across-the-board curiosity regarding alternatives to standard carrier relationships, which is what leads us here. (more…)
Guiding plan members with substance abuse issues to the appropriate network treatment resources has long been a challenge. As if taking the important step of seeking treatment isn’t difficult enough, rapidly identifying the right local resource with available capacity tends to complicate the issue.
A lack of available information, coupled with a sense of urgency, often results in members selecting costly out-of-network treatment options. But thanks to a few new online resources, that problem could be a thing of the past. (more…)