If you are a status quo broker your two best friends are………………….
Continue reading Who Are A Status Quo Health Insurance Salesman’s Two Best Friends?
If you are a status quo broker your two best friends are………………….
Continue reading Who Are A Status Quo Health Insurance Salesman’s Two Best Friends?
This is a suit where the hospital alleged numerous claims against the RBP vendor and the RBP vendor responded with a motion to dismiss………………………..
Continue reading Important Decision For Reference Based Pricing Lawsuit?
Every medical community has a Dr. Hodad (Hands of Death & Destruction). Peers never talk about Dr. Hodad for fear of lawsuits…………………………………………..
Harvoni drug cost in the US for a three month, 84 tablet course of therapy, is $94,500. The same drug if purchased in India for example costs $900 for 3 months 84 tablet course………………
Continue reading Generic Substitute for $94,000 Drug To Be Released Jan. 2019
Our solution pays pre-negotiated rates to hospitals and facilities at various rates of Medicare pricing…..…
Continue reading HealthSmart Reference Based Pricing Strategies
Health insurance carriers face slow but steady disintermediation by innovative next generation benefits advisers who are using alternative funding to take control of employer health plans and reduce costs………..the beginning of the end of these dinosaurs
The movement away from deductibles illustrates a growing sentiment that exposing patients to more out-of-pocket healthcare costs doesn’t solve the cost conundrum and could harm patients’ health…….
The 86th Texas Legislature will convene on Jan. 8, 2019. While TRS cannot speculate on specific outcomes, the Texas Legislature may make changes to the health care program. If there are changes, we will notify our members in writing.
Continue reading TASA Hints At Potential TRS ActiveCare Changes
Turning Bronze Plans into Gold Plans at Bronze Plan costs is a common but unspoken strategy……………but who is benefiting from “beating the system?”
Employees’ medical claim expenditures have increased in recent years, causing the health fund to deplete so significantly that the proposed budget for the 2019 fiscal year allocates an additional $1 million for the health fund…………….
Continue reading Three Victoria City Employees Criticize Proposed Health Insurance Plan
TASA advocates for alternatives to TRS-ActiveCare that would provide additional options to districts while sustaining the current system for those districts that remain in the system…………..
Continue reading Texas Association of School Administrators Advocates Alternatives To TRS ActiveCare
Leaked contract with Express Scripts, the nation’s largest PBM, gets crafty with its definition of “rebate.” The contract carves out so many exceptions to the “rebate” that the PBM itself ends up retaining most of the negotiated discounts for itself.
If PBMs drive up Rx costs, why use them? Why not deal directly with each pharmacy and cut the middle man out? A small Texas county is doing just that with significant savings……………..
Continue reading It Depends What The Meaning of The Word “Is” Is
By William Rusteberg
With the growing suggestion that the BUCAs are inflexible third party administrators unwilling and unable to administer Reference Based Pricing plans and other strategies in the market today, more brokers are seeking new partnerships with independent third party administrators (TPA). An independent TPA can offer much more than a traditional carrier model.
The Senate late Monday passed a bill that would put an end to gag clauses that bar pharmacists from telling consumers when it would cost less to pay cash for a prescription than to shell out the copayment under their health plan………………..
Continue reading Senate Votes 98-2 to Ban Pharmacist Gag Clauses
“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.” – Bill Rusteberg
Continue reading Xerox, Eastman Kodak And Cost Plus Insurance
Contracts with insurers allow hospitals to hide prices from consumers, add fees and discourage use of less-expensive rivals………………………. Continue reading Secret Hospital Deals That Squelch Competition
The most powerful selling tool is fear. It motivates buyers to act quickly and decisively without basis of reasoned consideration. Depending on the level of fear a seasoned salesman can gin up during his close, fees to be charged and eagerly paid by the victim are directly and proportionally related. Higher fear levels bring higher fees.
Hospitals create chargemaster prices by multiplying the cost they pay for a product by 300 to 1200%. Another little hospital secret is what is called an outlier payment…………………….
Continue reading How Hospital Reimbursement Does and Does Not Work
The Las Vegas Metro Chamber of Commerce announced Wednesday that it is partnering with Anthem Blue Cross Blue Shield to offer health plans to its members under a new Trump Administration rule that makes it easier for small businesses to collectively purchase insurance…………….
Continue reading Anthem To Offer New Association Health Plan in Las Vegas
Percentage of Charges Model – 50% Off Double The Price?
Hospitals are generally not paid 100% of billed charges; however, hospital outpatient
departments are routinely reimbursed as a percent of billed charges by commercial payers……
Continue reading Study Shows Hospitals Charge 479% of Their Cost For Drugs
Medical debt is a problem for 39% of insured adults in this country. 1 in 8 of those are on the hook for $2,000 or more. For more than 20 years RiskManagers.us has assisted members by reducing medical debt. As more employers cost shift to their employees, demand for medical debt reduction services is at an all time high………………………………
Continue reading Demand For Medical Debt Reduction Service At All Time High
A Texas municipality, facing rising health insurance costs, puts annual budget on hold until employee health insurance costs are negotiated. Maintaining city services and the expense of rising health care costs at the same time is Mission Impossible. Will Tax Man come to the rescue………………………?
Continue reading City Budget Hinges On Employee Health Insurance Price
Offers zero-interest funds for out-of-pocket medical expenses…………….
Continue reading MedZERO Launches in Salt Lake City in Partnership with Asserta Health
They changed over my status to “self pay” which cut my $10,400 the bill by 55%…………..