Diagnosed with the “Big C?” At least 10% beat it because they didn’t have cancer in the first place……...
Continue reading Shoddy Health Care, Missed Diagnosis, Unnecessary Treatment……….
Diagnosed with the “Big C?” At least 10% beat it because they didn’t have cancer in the first place……...
Continue reading Shoddy Health Care, Missed Diagnosis, Unnecessary Treatment……….
UHC Company Executives?
A Florida federal judge stepped down Monday from a proposed class action claiming UnitedHealthcare improperly classified a certain cancer treatment as experimental to avoid providing coverage, saying his personal opinion prevented him from ruling fairly on what he called “immoral and barbaric” actions.
Continue reading Judge Recuses Self Over Views On Insurer’s ‘Barbaric’ Policy
“An employer maintaining a workplace clinic (or considering one) needs to understand the group health plan compliance risks and the general risks associated with doing so and take reasonable steps to mitigate those risks.
Continue reading Is Your Employer Worksite Medical Clinic a Group Health Plan?
We have Medicare for all already………………………………………..
Meanwhile, back at the ranch, the Texas legislature kicks the can down the road……………..again.
Continue reading States Look To Medicare-Based Reference Pricing Strategies
One simple test, we can improve quality of life and save healthcare resources……………..
Continue reading The Future of Personalized Medicine is Here
Blue Cross Blue Shield of Texas removes 14 DFW hospital emergency rooms with out-of-network docs from network………………….
Will food program drive down health care costs in Chicago and Dallas? A portion of your BCBS premium dollars will be allocated to find out……………
Imagine if you need some sort of surgical procedure like a knee replacement. Simply go on-line and book it. Your employer has arranged to pay the providers you select prior to services rendered, including all or a part of your share of the cost. It’s that easy.
Continue reading Texas House Bill 3933 – A Panacea for Reference Based Pricing Plans?
RFQ 2019-0006 Package for a Consultant for Health Insurance for Webb County can be obtained from our EBid site located at: https://webbcountyebid.ionwave.net/CurrentSourcingEvents.aspx
Trustees project Medicare trust fund will be depleted in seven years………..So let’s do Medicare For All and see if we can go broke faster……………………………Never mind. Sam, fire up the ole printing press will ya………..we’ed be needing some money to pay for all this.
Continue reading Going Broke? Never Mind, Just Print More Money
“The main impact of digital business models is on company evaluation, which reflects the hype that some companies have created in the investor community. Companies like Oscar, Clover Health, and Bright Health are valued at over $1 billion USD each after only a few years of operation.”
Continue reading Disruptive Digital Business Models For Health Insurers
At first glance Texas Senate Bill 1530 looks appealing. Balance billing protection for self-funded health & welfare plans would be a welcomed gift from government, especially among purveyors of Reference Based Pricing plans.
Continue reading Texas Considers Balance Billing Legislation For Self-Funded Plans
Morning Shift Arriving At Work
One in three workers reported using prescription pain relievers — the majority under treatment of a physician………………………
Continue reading 33% of U.S. Workforce Using Prescription Pain Medications
In the article by Marshall Allen that follows patient questions why Aetna paid a grossly inflated rate of more than 300% of Medicare for his in-network claim. Well, that’s not the way Aetna or any other managed care company wants you to look at it. Instead they want you to focus on “discounts.” Managed care companies like Aetna reinforce that focus by sending patients EOB’s highlighting those amazing and magnificent discounts applied against billed charges. Could it be you may be looking at a 50% discount off double the price?
Continue reading Insurer Paid +300% of Medicare But The Discount Was Really Good
Behind the Scenes, Health Insurers Use Cash and Gifts to Sway Which Benefits Employers Choose
The insurance industry gives lucrative commissions and bonuses — from six-figure payouts to a chance to bat against Mariano Rivera — to the independent brokers who advise employers. Critics call the payments a “classic conflict of interest” that drive up costs.
PPO’s are a fraud and more are beginning to understand that. The only thing PPO’s can guarantee is the promise of no balance billing. That’s a powerful and effective coercive method used to foster obedience to status quo strategies of the past 35 years. However, the truth is we are all running out of money to fuel the American Healthcare Monster. Breaking away from status quo solutions will soon become a national epidemic towards fundamental change bringing sanity to health care costs in this country – Bill Rusteberg.
Continue reading Reason & Logic Won’t Move TRS ActiveCare Trustees
We’re excited to have a contract for services with the Texas Free Market Surgery Center. Our Texas clients who join the Oklahoma State Medical Association (OSMA) health plan will now have access to bundled pricing in Austin, Texas.
Continue reading Another Win For The Oklahoma Medical Association
McAllen Independent School District (the “District”) invites your submittal on: RFP No. 2018-200 – Fully Insured Dental Plan…………………….
Continue reading Fully Insured Dental Plan Request for Proposals
The TRS ActiveCare plan for Texas school districts is imploding. Many want out of the program…….
The Ebbinghaus Study is widely accepted as a definitive study in human intelligence. The study concluded that within 24 hours we will forget 75% and within 30 days we will forget 90%. The remaining 10% will remember only 5%.
Continue reading Scientist Proves Employee Benefit Meetings Are A Waste of Time
“People are going to jail over ERISA fiduciary violations and the dollar amounts pale in comparison to what is being wasted on the employee health plan side of ERISA.”
Continue reading Why Do Some Fiduciary Violations Go Unpunished While Others Result in Jail
Dr. Dave opines again on Medicare supplemental insurance policies…………….
Continue reading Is Medicare Supplemental Insurance Worth It?
The North Carolina Blue Cross Blue Shield “My Choice” policies aim to change the way doctors and hospitals are paid by limiting reimbursement for services to 40% above what Medicare would pay. The plan has no network of doctors and hospitals…………………
Continue reading RBP Market Growth Continues – Blue Cross Adopts No Network Model
Hospital demands almost 2,000% of Medicare to settle claim………………….
Continue reading Hospital Insults Plan Sponsor – Wants 1,947% of Medicare
A new survey from Gallup shows that Americans borrowed a staggering $88 billion in 2018 to pay for health-care costs that were not covered by their insurance plans………..….
Continue reading Health Insurance Bankrupting Americans – Personal Debt Reaches New Highs
Activated immune cells travel throughout the body, killing tumors wherever they find them…………….…
“Conditions and diseases of healthcare systems which are relevant to this discussion include: incentive malalignment syndrome, hypermetricosis, benefit managementosis, maladaptive dysdocumentosis and more.” – Texas Physician
Continue reading Surprise Medical Bills – Two Texas Physicians Respond
Senator Cruz Proposes 4th Method To Reduce Drug Costs?
In an unprecedented move, Tx. Senator Ted Cruz introduces Senate Bill to free the worlds most successful drug importer. “Chapo has proven cheap and effective drug importation is possible! With his direct-to-source plus vast American distribution system, El Chapo, his organization has the where with all to help solve our broken health care delivery system. FREE CHAPO!
Continue reading 3 Ways Employees Can Reduce Prescription Costs
By Alex Olgin • Mar 25, 2019
For the more than 40 doctors at Lakeside Family Physicians and Huntersville OB/GYN, the move away from Novant Health is a return to how they used to practice medicine. Both groups were independent before joining with Novant about 15 years ago.
Continue reading Doctors Practices Leaving Charlotte Hospitals Catch The Eye Of Their Industry
Many big companies are mining data from their own health plans and public records and working with consultants to compare physicians, searching for those with the best results and competitive costs.
Continue reading Employers Get Choosier About Workers’ Doctors
Jeanne Pinder scores big with TED talk…………………….
Continue reading A Million Views in 44 Days! ClearHealthCosts Price Transparency TED Talk Goes Viral
By Bill Rusteberg
Last year I had the privilege to make a presentation to the Board of Trustees of a Texas independent school district. The district’s self-funded health & welfare plan was in trouble and they wanted to hear how we have been able to keep costs static over time for other school districts we have been fortunate enough to manage over the past twenty years. Those districts have beaten medical trend while improving benefits at the same time and at half the cost.
Continue reading Status Quo Consultants vs New Age Consultants
Insulin manufacturers and PBMs have faced mounting pressure amid outrage over the rising cost of insulin, a nearly century old lifesaving drug.
Continue reading Outrage Over Rising Costs of 100 Year Old Drug
Clarity Benefit Solutions is a broker-friendly benefits technology company and TPA for Tax-Advantaged Plans with 25+ years of industry experience. Our easy-to-use programs and tools are designed to innovate, integrate, and automate – taking the frustration out of benefits with solutions that actually work.
Continue reading Clarity Benefit Solutions – TPA for Tax Advantaged Plans
You can walk into your local drugstore and buy a month’s supply of Aleve and Nexium for about $40. For Vimovo, the pharmacy billed my insurance company $3,252.
Continue reading How Two Common Medications Became One $455 Million Specialty Pill
Stringent government control of health care continues to defeat efforts of free market proponents……………….
Texas Free Standing Emergency Rooms (FSER) resemble urgent care centers, but on average, an FSER costs 10 times as much as an urgent care visit for the same condition……………..
Continue reading Texans Support Consumer Protection Laws Against Medical Price Gouging