In Focus

News & Insight from Chelko Consulting
What’s the Rush?

What’s the Rush?

 “The Food and Drug Administration (FDA) is responsible for protecting the public health by ensuring the safety, efficacy, and security of drugs, biological products, and medical devices.” It’s right there in their job description.

But with the release of new policies meant to promote innovation for patients with unmet clinical needs, the FDA is asking the American people to “accept some level of uncertainty” when it comes to a handful of gene therapies that have been fast-tracked through the approval process. read more…

In Search of Healthy Competition

In Search of Healthy Competition

There was a recent article in a North Carolina newspaper about a local surgeon, Dr. Gajendra Singh, who wanted to offer transparently priced, low-cost services to assist patients that are candidates for general or laparoscopic surgeries.

What was fascinating about the article wasn’t that the surgeon was still practicing independently (which seems very rare these days), or that he posts the cost of an x-ray on his front door (which is also rare, and admirable). The intriguing part was that he wanted to purchase an MRI machine and the State of North Carolina wouldn’t permit it. read more…

Keeping Score: Network Performance

Keeping Score: Network Performance

How well is your PPO network performing?

If we’re talking breadth of access and depth of discounts ― it probably looks pretty good! As far as helping you secure lower costs than their competitors ― it’s probably not making a big difference. read more…

Unsung Hero: The HSA and Retirement Savings

Unsung Hero: The HSA and Retirement Savings

When employees ponder their lives in retirement, hobbies, travel, and mid-afternoon naps are likely more top-of-mind than paying for healthcare.

Even with Medicare picking up the majority of healthcare expenses for post-65 retirees, the average couple will still need $390,000* to cover medical expenses during retirement. And that doesn’t even include long-term care. The problem today is that the average retirement savings for a couple in their 60s is only $152,000**. read more…

Keeping Score: Specialty Drug per Employee Cost Trend

Keeping Score: Specialty Drug per Employee Cost Trend

Specialty drug per employee cost trend refers to the change in specialty drug spend per employee from 2017 to 2018 for each company in our database. While the average increase of 11% is right in line with benchmarks, the year-to-year price movement for each company is all over the board. Only 15% of the groups in our database had a trend rate between 10% and 15%. read more…

We’re Paying You for What?

We’re Paying You for What?

The prescription drug market is officially upside down. We were recently looking at a large coalition’s new initiative to “remove unnecessary drugs” from its formulary. The plan, believe it or not, is to charge coalition members over $3 million in fees to exclude these expensive, unnecessary drugs.

Our response: Really? We have to pay them extra for that? Why were those drugs covered in the first place? Weren’t we already paying them to help us avoid spending money on expensive, unnecessary drugs? read more…

A Look Behind the Curtain

A Look Behind the Curtain

We just received another invitation to take advantage of an insurance company’s “supplemental compensation program.” Every time we see these solicitations, we feel our blood pressure rise. It certainly reinforces the practice of insurance companies referring to brokers as their “producers.” read more…

Will New Price Transparency Rules Have an Impact?

Will New Price Transparency Rules Have an Impact?

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. read more…

Rethinking Telemedicine

Rethinking Telemedicine

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. read more…

Do Employee Meetings Still Have a Place in Benefits Education?

Do Employee Meetings Still Have a Place in Benefits Education?

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. 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

Employee Phone Directory