Health Rosetta Outlines Difference Between Status Quo Broker & New Age Broker

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Does this describe your broker? If so, you probably need to look for another one:

  • “Shops” the insurance every year
  • Facilitates insurance 1 year at a time
  • Believes costs are dependent on the best offer of the carrier
  • Gives limited data on where your money is going
  • Provides limited ways to control underlying costs
  • Doesn’t talk about their compensation or worse, is solely paid on commission, meaning more income the more rates go up
  • Advocates cost shifting in the form of increased deductibles and copays to lower the employer impact of premium increases
  • Blames costs exclusively on employee behavior and poor health

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Stricter Chargemaster Regulations Needed To Rein In Healthcare Costs

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“It’s Not My Fault They Read My Book!”

Hospitals use fairy tale chargemaster pricing — which are shrouded in secrecy — to negotiate with third-party payers and generate revenue, yet Hospitals Dismiss Significance Of Chargemaster Prices?. A good negotiator, seeking maximum profits, always starts out high……Hospitals know the Art of The Deal…………..
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How Late Will Late Adopters Be Late?

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It’s been eight years since I wrote Health Care Strategies for Texas Political Subdivisions: costplusinsurance.com/articles/Health%20Care%20Strategies%20for%20Texas%20Political%20Subdivisions.pdf

Since then there have been early adopters who have blazed the trail for others to follow. But most Texas political subdivisions still have their heads in the sand.

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Health Insurance is NOT Health Care

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I’ve said for years that one of the main reasons ObamaCare passed was because they did a great job of confusing Health Insurance with Healthcare financing, or Healthcare.  I recently ran across the attached article that does a great job of addressing this point and wanted to share it.  I hope you enjoy it as much as I did.

Have a great day!   Jeff Evans, Director, Benefit Services jevans@healthplan.org

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Craig Lack – “The Most Effective Consultant You Never Heard Of”

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Craig Lack is “the most effective consultant you’ve never heard of,” according to Inc. magazine. He consults nationwide with C-suites and independent healthcare broker consultants to eliminate employee out-of-pocket expenses, predictably lower healthcare claims and drive substantial revenue.

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AMPS Announces Investment to Continue Rapid Growth

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“Last year AMPS grew by over 70% and we are on a financial track to do the same this year,” said Dendy.  “However, beyond financing, we also see the new investors as an opportunity to build and expand our leadership footprint in healthcare cost management services for employers, health care plans, and government entities.”

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Is Direct Contracting the Right Strategy for Your Organization?

mulebriarConnect with employer and provider peers who are actually developing and strengthening direct contracting relationships to discuss the pros and cons of direct contracting at the 3rd Annual Employer-Health System Direct Contracting & Partnership Strategies Summit on July 25 in Boston.  Gain insights into such questions as:

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Protection Money In Health Care

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Paying protection money (PPO access fees) for the promise of no balance billing against egregious, arbitrary sticker pricing that has no relationship to costs whatsoever, and agreeing to provider reimbursement levels based upon secretive contracts you cannot see or audit, violates fiduciary duties and is contrary to basic, common American business practices.

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AMPS

AMPS_Blue111“Over the last 3 years, AMPS average reimbursement level on hospital claims has averaged 156% of Medicare or approximately 37% less than PPO reimbursement levels. For every 1,000 employees on an employers’ health plan, this 37% decrease in cost equates to approximately $2,550,000 in savings.” 

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Texas Legislature To Tackle Balance Billing Issues – Jeff Evans Opines……….

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As a citizen of the great state of Texas, I am curious about the introduction of several bills designed to “ensure health plans are discouraged from underpaying providers.” – Jeff Evans

To Jeff’s point, David Silverstien addresses a basic problem with government interference in our health care system:

“We recommend extensive legislative education. We genuinely believe that legislators do not understand the true nature of healthcare pricing and that, as the paramount issue of our time, they must. Our form of government is grounded in the expectation that the citizenry elect wise and noble people who then study the issues before them to an extent not possible by the general public. The nature of healthcare pricing is such that the limited knowledge of legislators is approaching the danger level.” – David Silverstien

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Tenet, BCBSTX Sign Multi-Year Agreement

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For those of you insured by BCBSTX, would you like to know what kind of prices have been negotiated for you at Tenet Healthcare? Maybe your prices went down?

As a BCBSTX policy holder, whether you know it or not, you have a dog in this pricing arrangement. Why don’t you ask to see a copy of the negotiated contract? After all you will be subsidizing the agreement as a premium paying card carrying member of the Caring Company, right?  

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