As the future of healthcare lingers in a national debate, Crowne Consulting Group, Inc.delivers achievable ways for employers to decrease medical expenses while enhancing care for employees.

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Is this the beginning of Amazon’s move into the healthcare industry?

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The costs shared here are what the pharmacy actually pays; not AWP, MAC or WAC…………

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The Republican party is split. The Democrats are unified. This is a perfect case where “You don’t interfere when your opponent is committing suicide.”

The European slug is average in every way: slimy, brownish, shorter than a credit card. But Arion subfuscus has a minor superpower………………

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Health care ministries are essentially cost-sharing programs. Members’ monthly fees are applied directly to other members’ medical bills, no matter where they live in the U.S. 

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UHC Sales Rep. Reacting To News

FOX 8 has obtained a document – among the most sensitive in the healthcare industry……….A local provider sent us a spreadsheet that shows his businesses’ negotiated rates with three insurance companies, Blue Cross Blue Shield, United Healthcare and Humana………………

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Facilitating cash pay arrangements for self-funded employers and health plans, achieving significant savings in partnership with medical care givers………………..

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TRS Health Programs Imploding Faster Than A Melting Raspa

The Texas Teachers Retirement System health plan changes have been announced for January 1, 2018 and they are not impressive…………………TRS Participants are beginning to picket on the State Capital steps in Austin.

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Out-of-network billing allows physicians to significantly increase their payment rates relative to what they would be paid for treating in-network patients…………...

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Medical stop loss doesn’t have to be a boiler plate, off the shelf, cookie cutter product. It needs to be innovative and compelling.

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m.youtube.com/watch?v=e2yzlW_XVZk

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Contributed by Mike Reagan

video.foxnews.com/v/5518549927001/?#sp=show-clips

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More and more employers with self-funded health plans are turning to reference-based pricing to reduce their overall spend. They like the deep savings, and they appreciate the price predictability regardless of which provider the plan member uses.

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Designed specifically to address rising healthcare costs for employers with 5 to 99 employees, Healthy Choices plan designs generally calculate reimbursement amounts for healthcare services using reference-based pricing. This approach results in a reasonable fee, which is a multiple of Medicare’s reimbursement rate…………….

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Mike Dendy

The health insurance industry is a cartel and cartels have to be broken because by definition they can’t be fixed………………………

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Apex Benefits, an Indianapolis-based benefits consulting firm, develops innovative strategies and programs to provide employers unique, cost-savings health benefits programs…………

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I’m very fortunate to be able to collaborate with a group of true reformers from around the country.  We’re committed to transforming our current system of inefficiencies into an efficient system where primary care is empowered, quality and outcomes are measured, and the price tag for services is greatly reduced – Richard Sutton

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Insurance companies create vast networks, referred to as PPOs (Preferred Provider Organizations). The only thing that is preferred is the deal the insurance company cuts itself. About a full one third of the total medical spend by an employer can be eliminated by removing in-network pricing variation for commodity care alone. 

Employers need to realize that when they pay for PPO access, they are paying to access a network designed to maximize the insurance company’s revenue – not to save the employer money on medical care. 

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Democrats are in orgasmic euphoria……………..

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Murry B. Cohen, Appellate Lawyer 

Gloria Hicks, v. Group & Pension Administrators, Inc., 13–14–00607–CV, (Tex. App. 2015). Reversing District Court and holding that a citizen’s email to school board trustees urging the board not to contract with plaintiff concerned a matter of public importance, was not commercial speech, and defendant was protected from suit by the Texas Anti-SLAPP statute.

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Managed Care Executive

We just can’t think anything other than they are as stupid as stupid gets…….……

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The problem facing political subdivisions in seeking competitive bids are many. Politics almost always plays a pivotal role in the process and oftentimes encompasses a mixture of ignorance, money, clan loyalties, and employment.

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Unwrap Me Please!

With Phia Unwrapped, The Phia Group replaces wrap network access and modifies non-network payment methodologies, securing payable amounts that are unbeatably low, based upon fair market parameters.

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Republicans are going to fund Obamacare subsidies that the Democrats forgot to fund?

It will be voter payback time in 2018 – Lily Livered, Yellow Bellied Cowering Republican elites will be targeted for punishment……….Too many lies for too many years will impact the 2018 mid term elections. 

The Democrats are smart. They have learned “Never interfere when your opponent is committing suicide”

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Joe’s choice of beer is a good example of his philosophy. He knows that in order for beer vendors to stay in business they must agree to sell based upon the price Joe and others are prepared to pay……………

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Mike Dendy, MBA/MHA, vice chairman & CEO, Advanced Medical Pricing Solutions (AMPS) is certainly a market leader and really “gets it”…………..…..Laura Carabello

In 2013 I wrote “Xerox, Eastman Kodak And Cost Plus Insurance” which predicted the inevitable rise of the Mike Dendy’s of the world.(See article at end of this blog entry).

In the article I wrote: “The challenge facing successful business ventures is to understand the necessity to continuously respond to market forces in a proactive manner since competition will certainly become a factor to consider at some point. To ignore this basic business premise by remaining complacent is business suicide……………..pioneering, successful business endeavors that fail to react quickly and appropriately to market threats end up losing market dominance……………….”

And then, as predicted, (a) Mike Dendy gobsmacked the market with a set of fresh eyes. His company, AMPS, has since become the national leader in Reference Based Pricing strategies, experiencing phenomenal market growth.

“Companies must work constantly to eliminate any cost factor that does not add value to a business process” – Mike Dendy

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Texas Supreme Court has ruled state governments do not necessarily have to extend marital benefits to same-sex married couples………………

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This case involves the relationship between hospital system and insurance company, and how that relationship affects everyday patients and consumers……..

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The shared vision of RiskManagers.us and clients who retain our services is to establish and maintain a comprehensive employee health and welfare plan, identify cost areas that may be improved without cost shifting to any significant degree, and ensure a superior and sustained partnership with a claim administrator responsive to members needs on a level consistent with prudent business practices.

Plan costs, in all areas including fixed expenses and claims are open for review on a continuing basis. Cost effective plan administration and equitable benefit payment to providers are paramount to fulfilling our mutual fiduciary duties. As we proactively monitor and manage an entire benefit program we are open to any suggestions members may make or the dynamic health benefit market may warrant in order to accomplish these goals.

Duty of loyalty to our clients, transparency and accountability are essential to the foundation of our services. To that end, we expect our clients to realize a substantial savings based upon the services that we will deliver.

2017 RiskManagers.us All Rights Reserved           

Email: RiskManager@RiskManagers.us

By William Rusteberg

Selection of a third party administrator (TPA) is crucial to the success of a self-funded plan. Criteria usually revolve around several factors including compatibility. Corporate philosophies of the employer and TPA should harmonize.

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ID Watchdog Signs Agreement to be Acquired by Equifax Inc…………..

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The average premium for a high-deductible health plan for a retired teacher under 65  with no beneficiaries could rise from $1,300 to $9,550 in 2018, under the legislature’s fix…..

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Having the right claim payer for your company’s healthcare program(s) will make a positive impact to your bottom line and employee productivity……………..

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The hospital industry is participating in a massive flea market, with large chains buying and selling hospitals like Pokémon cards or Monopoly properties.

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Prime Healthcare Foundation has a record of purchasing distressed hospitals and making them profitable…………………….

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Once it’s out there it can be sold on the black market………………

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Last August, the center reported a 77 percent drop in its adjusted income over a 10-month span, then recorded an operating loss of more than $111 million for September through November 2016. In response, MD Anderson shared plans to eliminate roughly 1,000 jobs from its 20,000 and it also called of its collaboration with IBM Watson, which was projected to cost more than $62 million.

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Nobody is proposing to cut Medicaid. Republicans are merely proposing to limit annual spending increases…………….

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Founded in 2009, MDLIVE is a leading telehealth provider of online and on-demand healthcare delivery services and software that benefit patients, hospitals, employers, payers, physician practice groups and accountable care organizations.

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Use the Tenth Amendment to deal with this problem, like the Founders intended……

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