Trump Plans To Revamp Employer Based Health Care

The Beginning Of The End of Group Health Insurance?

The proposal would allow companies to use HRAs to reimburse employees’ premiums on the individual health-insurance market……………………….In lieu of adopting a group medical plan for employees, an employer can give employees money to purchase individual health insurance in the open market....

Continue reading Trump Plans To Revamp Employer Based Health Care

If You Can’t Beat Them, Join Them

Earlier this month we learned the state of North Carolina will be terminating their state health plan’s contract with Blue Cross and will instead adopt a Reference Based Pricing plan (Another State Adopts Reference Based Pricing Strategies). Now we learn Blue Cross of N. Carolina will be introducing a new, no network health plan, which is of course, Reference Based Pricing. Is this a case of “If you can’t beat them, join them?”

“It is normal comprehensive insurance, with a high deductible, and the main difference being that reimbursement is based on a ‘reference pricing’ approach similar to what state Treasurer (Dale) Folwell has recently proposed for the state employee plan…………….”

Continue reading If You Can’t Beat Them, Join Them

Texas Spanks Humana – Who’s Gonna Pay For It?

Now let me get this straight. Humana tries and fails to negotiate a reasonable rate with enough in-network providers and is punished for it. Well, the solution is to get rid of the network and treat all providers as out-of-network. That’s what Reference Based Pricing plans do.……………..BTW guess where Humana is going to get the $700,000………………………..

– Bill Rusteberg

Continue reading Texas Spanks Humana – Who’s Gonna Pay For It?

Another State Adopts Reference Based Pricing Strategies

First it was Montana, a smallish state somewhere up north of us, who adopted Reference Based Pricing for their state health plan (Montana Adopts Reference Based Pricing Strategies). The little lady up north has big brass cojones! (Tough Negotiator Saves State Millions In Health Care).

Next there is California which is currently considering similar efforts. (California Assembly Bill 3087 Would Control Prices in the Commercial Market).

Now there is yet another state adopting Reference Based Pricing for their state employee plan. They must have heard about the little lady in Montana.

I thought Texas would lead the country on this. After all, several of us have been making noises in Austin over the past two years. Has Texas Lost It’s Cojones?.

– Bill Rusteberg

Continue reading Another State Adopts Reference Based Pricing Strategies

Tough Negotiator Saves State Millions In Health Care

 Marilyn Bartlett

Marilyn Bartlett took a deep breath, drew herself up to her full 5 feet and a smidge, and told the assembled handful of Montana officials that she had a radical strategy to bail out the state’s foundering benefit plan for its 30,000 employees and their families………………..

Will Texas be next?

Continue reading Tough Negotiator Saves State Millions In Health Care