In Focus
News & Insight from Chelko Consulting
Another Day, Another Shell Game
If you’re a plan sponsor, you’re probably familiar with the drug Humira. That’s undoubtedly because it appears toward the top of your list of costliest drugs. Well, that might change soon. Or maybe not. It’s tough to tell. read more…

Strange Bedfellows: High-Cost Drugs and Peace of Mind
What keeps you awake at night? For a couple years now, we’ve written about the number of mega-expensive new cell and gene therapies in the development pipeline. By “mega,” we generally mean therapies costing more than a million dollars. read more…

“Independence Changes Everything!”
I recently saw this statement in big bold letters on the last page of a report issued by one of our competitors. I agree, independence can be a real game-changer. But what is “independence” in this context? read more…

Grateful for a Dream Come True!
With 20 years now under our belt, I can’t help but feel so grateful for where we are as a firm, where we’ve been, and where we’re going. read more…

Effective Transparency Tools Come at a Price
It’s not uncommon for the average healthcare consumer to be in the dark when it comes to the value of services received. We’re typically oblivious to the cost and quality of each service until the bill arrives or something goes wrong ― like when a revision to a hip replacement is necessary. And such blind faith can be a significant driver of rising healthcare costs.
Recent legislation is putting more emphasis on price transparency in hopes it will lead to increased consumerism and, in turn, more value. Many employers have followed similar logic and purchased consumer tools from their insurance provider or a third-party service. read more…

Deep Dive Redux: Benchmarks and Beyoncé
June arrived with a splash at Chelko, as we explored findings from our sixth annual Deep Dive employer survey. While we were limited to a virtual presentation for the second straight year ― a departure from our traditional all-day gathering in Columbus ― we were still able to provide a robust discussion around what is driving medical and drug spend for the 50 participating employers in markets across Ohio and beyond. read more…

Nothing to Hide Here
You can see right through us. And we’re totally fine with that.
For plan years beginning on December 27, 2021, or later, brokers and consultants will be held to new compensation transparency obligations under the Consolidated Appropriations Act (CAA). The CAA creates new requirements for brokers and consultants (referred to in the rules as “covered service providers” or “CSPs”) to disclose to ERISA-covered group health plan sponsors any direct or indirect compensation they may receive for referral of services. read more…

We Look at Things Differently. So Should You.
Chelko uses our unique clinical and sourcing expertise to dramatically reduce drug benefit costs for plan sponsors and improve member care. While others mistakenly chase discounts and rebates, we focus on removing waste and excessive profiteering from plans and helping members more affordably get the medications they need.
The fact is, too many people are using old strategies to take on new challenges. While brand and generic medications make up almost 99% of total prescriptions and have long been the primary focus of most cost reduction efforts, it’s more than time to shift our attention to the other 1%. read more…

Pumping the Brakes on Accelerated Approvals
The world is full of patients suffering from diseases without available therapeutic options and the FDA’s “accelerated approval” pathway offers many an additional degree of hope. Introduced in 1992 and later modified in 2012, the program is not without its downsides. read more…

Bullet Holes & Benefits: Measuring What Matters
Maybe you’ve heard this story before, but probably never as it relates to employee benefits.
During World War II, planes would come back from battle riddled with bullet holes. The Allies did an analysis and determined which areas of the returning aircraft were most commonly hit by enemy fire. In doing so, they hoped to reduce the number of planes shot down by adding additional armor plating to those frequently damaged sections. read more…
INSIGHTS & RESOURCES
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