In Focus

News & Insight from Chelko Consulting
Taking the Deep Dive with Nicolas Cage

Taking the Deep Dive with Nicolas Cage

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. read more…

Medical Carrier or TPA: What’s Best for You?

Medical Carrier or TPA: What’s Best for You?

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. read more…

Online Resources Speed Access to Substance Abuse Treatment

Online Resources Speed Access to Substance Abuse Treatment

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. read more…

Who’s the Boss?

Who’s the Boss?

You’re an employer. You are the buyer. You hold the cards in deciding which medical and prescription drug plan vendors you work with, and the price you’re going to pay. You are the boss, right? read more…

Keeping Score: Discount Off AWP for Prescription Drugs

Keeping Score: Discount Off AWP for Prescription Drugs

Prescription drug discounts are calculated by looking at the Average Wholesale Price (AWP) and the actual drug cost (sometimes called the “ingredient cost”). In looking at our employer data set, it is interesting to note very little correlation between higher discounts and lower per employee per year drug costs. This indicates the mix of drugs being dispensed, and other pricing games, are offsetting proposed and reported discounts. read more…

Maintaining Active Health Coverage for Disabled Employees

Maintaining Active Health Coverage for Disabled Employees

The Family and Medical Leave Act (FMLA) requires employers to continue coverage for certain employees as if they are still actively at work. But disability leaves outside the FMLA’s purview are a completely different story. There are no laws requiring employers to provide group health benefits in these other situations. So how do employers address this? read more…

Employers and the Future of Healthcare Data

Employers and the Future of Healthcare Data

Everybody seems to agree that “big data” holds much promise (or potential) for better healthcare. To this end, the Affordable Care Act made it a priority to create more, and presumably, better health care data. However, with the rapid development of devices, tracking systems and data tools, who will benefit from this data: Patients? Plan sponsors (or payers)? Insurance companies? Healthcare providers? PBMs? Pharmaceutical and device manufacturers? Other enterprising service providers? read more…

Keeping Score: Combined PEPY Trend

Keeping Score: Combined PEPY Trend

Overall trend looks at medical and prescription drug costs (claims and administration expenses) combined on a per employee basis year-over-year. While the average is somewhat expected, the 27% difference from highest to lowest illustrates that trend is not as linear as we might often think. Knowing your trend rate is essential, but more importantly, knowing if you are trending to the mean of per employee per year cost benchmarks or further away is critical to managing your plan.

How does your plan compare? Let us know if you would like to gain more insight into how to measure and manage your plan trend.

read more…

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24651 Center Ridge Rd, Suite 110
Westlake, Ohio 44145

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

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Phone: 614.869.4140

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