FOR IMMEDIATE RELEASE
Burger King In Acquisition Talks With Blue Cross
Scottsdale, Az – (March 30, 2018) – Burger King, home of the nation’s best, highest in saturated fats mouth watering burgers announced today they are in advanced discussions with Blue Cross on a possible merger.
In Martinsville, Virginia, there is a reference-based pricing lawsuit pending that industry insiders are watching closely, because it could set a precedent for these types of lawsuits moving forward. In this case, a Virginia hospital has been pursuing an $84,000 balance bill from a former patient for nearly four years and through two separate courts……………………
Health insurers and pharmaceutical companies are pointing fingers at each other for the rising cost of prescription drugs as scrutiny over drug spending intensifies………………..
Recent trends in the medical stop loss market are showing most stop loss risk managers have been suffering significant losses in the past few years.
A plan sponsor can self-fund the coverage a lot less expensively than insuring through a carrier…………..
Some employers that are exasperated by raising health care costs have quietly questioned whether it isn’t time for the government to take over the responsibility of providing health care through a single-payer system.
MGUs representing multiple carriers face a conflict situation whenever a marginal claim comes in from an important producer………………….
“You’ll be seeing drug prices falling very substantially in the not-so-distant future, and it’s going to be beautiful…………………”
This is an excellent 30 minute interview with Dan Meylan of Allied National on Direct Primary Care strategies. This, coupled with Reference Based Pricing, makes sense. Its a win win for the consumer, the plan sponsor, the insurance company and most importantly medical caregivers within respective communities.
The government’s attempt to prosecute Shafer as a dangerous FBI-stalking villain ended with a whimper instead of the bang the prosecutor hoped for…………………..Badge heavy FBI agents created private hell for Shafer and his family………………(Badge Heavy – A police officer who believes wearing a uniform with a badge makes him king of the universe. An arrogant police officer).
Amazon is setting up a mysterious new partnership with JPMorgan Chase and Warren Buffett…………..
Five interesting facts from the Kaiser Family Foundation on the decade impact on cost sharing on the enrollee:
Why should we care?
“Percentage of savings fees is the greatest fraud foisted upon consumers since Vicor Lustig sold the Eiffel Tower in 1925. To earn 24% of an inflated, arbitrary number that no one ever pays is better than robbing a
bank.” – William Rusteberg
CIGNA Sued for Rx pricing practices…………………..
A federal judge in Connecticut has denied most of Cigna Health and Life Insurance’s claims in its request to dismiss a lawsuit which alleges it artificially inflated prescription drug costs in violation of the health insurance policies of its clients………………
Allows the state insurance department to have oversight over PBMs and essentially treat them as insurers………………….
Thanks, but no thanks. We don’t believe you and we don’t want to save money and improve benefits at the same time. The fear of pissing off employees far outweighs our bottom line. Plus, we have less employees than we could have by redirecting health care dollars to grow our business. And, we pay our employees less because as the cost of health care increases the less they receive in wage increases. It’s a system we are used to after 40 years of managed care. So, go away please…………
Lawmakers seek to remove ‘gag clauses’ that keep pharmacists from revealing lower prescription drug prices…………………….
RiskManagers HealthCare Purchasing Coalition ™ is a high performance health care Management Services Organization founded on a simple proposition: Health care cost can be reduced while maintaining or even improving benefits at the same time.
Why on Earth do we insure office visits? And lab tests? We don’t insure fan belts or tires on our vehicle do we?
More employers are realizing they can save a lot of money by not insuring events that are predictable and quantifiable………………We know how to do that, do you? (Hint: Direct Primary Care Strategies).
Federal Judge Dismisses Lawsuit against Trump Administration’s End to Obamacare’s Contraception Mandate
Uber Inc. and its health-care partner, Stride Health, … asked the DOL in separate letters to allow workers with multiple jobs and varied hours to be eligible to participate in association health plans.
Prescription drug overpayments (also known as “clawbacks”) occur when commercially insured patients’ copayments exceed the total cost of the drug to their insurer or pharmacy benefit manager…..
A long time friend who has spent almost all of his working life in the pubic purchasing arena in Texas has a perspective that many of us in the insurance community have failed to acknowledge.
Dialysis treatments for End Stage Renal Disease (ESRD) patients are expensive, really expensive. They can run $600,000, $700,000 or more a year, easy.
We are continuously amazed political subdivisions like this one continue seek competitive proposals the old fashion way.
Changes will expand the pool of employers who may be eligible to create, join or establish a self-funded……
State public employee insurance programs are the early adopters of “Right to Shop” health care initiatives………………….Are PPO’s doomed?
The Affordable Care Act (ACA) is a federal government mandate all states must follow. As a reminder, the ACA is a “tax” and nothing more according to John Roberts. The federal government has the power to tax and the states are powerless to resist individually.
The Company plans to market to the 58 million Hispanics in the USA a health care sharing model that reduces the costs of coverage while providing quality and timely access to health care services.
“All advisors must endeavor to systematize their practices as much as possible so that they can remain competitive, highly profitable, and be in a position to grow in a disruptive and fee sensitive environment.” |
President Trump’s new health secretary issued a warning Monday to a room of hospital executives about soaring health care costs: change is coming, whether you like it or not.
Many purveyors of voluntary employee benefits offer “free” Cafeteria Plan administration in return for the opportunity to sell voluntary products such as cancer plans. A portion of the commissions earned by writing agents are shared with the Cafeteria Plan administrator thus affording “free” administration services to the plan sponsor.
Is this practice legal?
RxResults offers a multipronged approach to eliminate wasteful pharmacy plan spending on behalf of the employer and employee……………
This is your opportunity to speak with some of the nation’s leading experts as they outline new solutions to the current market………………..
“People should know what things cost in health care,” said Jeanne Pinder, founder and CEO of ClearHealthCosts. “We’re here to help.”
The Mulebriar organization has just released a redacted copy of a Direct Primary Care contract (DPC) of an organization that recently touted on social media they were the largest DPC provider in the United States.
Many plans are adopting Reference Based Pricing for their medical coverage. They can do the same for their Rx coverage.
