Are You Paying For A “Lexus” Surgery & Getting a Pinto?

lexusMoney that would have otherwise gone into investments or infrastructure development is now being diverted to employee healthcare benefits, and that has implications for the long term viability of every organization. (See Most Companies Shirk Fiduciary Duties When It Comes To Health Care)

MPIRICA offers free access to Provider Quality Scores for employers and plan participants……………..

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Most Companies Shirk Fiduciary Duties When It Comes To Health Care

bernieAn excerpt from the preceding post on this blog (Florida Business Coalition Set to Revolutionize Health Benefits Purchasing) says it all. Some plan sponsors are better at managing fiduciary duties than others. They take these duties seriously while others simply ignore common sense, fail to understand health care financing and rely on vested interests memorialized through contracts of adhesion.

Perhaps the finger of blame for the high cost of health care should be directed at the payer, not the medical provider community  – RiskManagers.us

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Florida Business Coalition Set to Revolutionize Health Benefits Purchasing

whydidnt“How many businesses do you know that want to cut their revenue in half? That’s why the healthcare system won’t change the healthcare system.” Rick Scott – Governor of Florida

Orlando-based Rosen Hotels have shown how straightforward it is to slay the healthcare cost beast. They spend 50% less on health benefits than a typical employer while providing outstanding benefits

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Rampant Out-Of Network Provider Litigation Continues

perrymason

Litigation involving out-of-network providers, meaning providers who do not have a negotiated rate agreement with the respective payer, continues to be rampant. Certain issues arise frequently in these lawsuits over whether the payers had properly paid claims.

This article discusses several published decisions from 2015 that illustrate how courts across the country are handling some of these common issues.

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Custom Design Benefits Announces Changes – True Cost Product Gains Momentum

mueller Julie Mueller

Munninghoff said his accounting firm’s experience with TrueCost influenced his decision to invest in Custom Design Benefits.

An exclusive new product called TrueCost, a reference-based pricing solution for firms with as few as 50 employees was developed by Custom Design Benefits in 2012, TrueCost eliminates deductibles and co-insurance and reimburses all medical providers based on Medicare plus a bonus.

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The Case of The Missing + 3%

What Do Three Men, A Hotel & A Third Party Intermediary Have In Common With Health Care Financing?

peopleIn this illustration, you will learn how RiskManagers.us skillfully portrays an illusion to reduce inflated billed charges by almost 17% , saving each of the three men 10% while enriching a third party intermediary by approximately 7% of billed charges with an additional + 3% vanishing inexplicably into thin air.

Understanding this riddle will clearly show how opaque and illusionary health care financing can be…………………..

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