Diagnosed with the “Big C?” At least 10% beat it because they didn’t have cancer in the first place……...

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“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.

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We have Medicare for all already………………………………………..

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Meanwhile, back at the ranch, the Texas legislature kicks the can down the road……………..again.

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One simple test, we can improve quality of life and save healthcare resources……………..

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Blue Cross Blue Shield of Texas removes 14 DFW hospital emergency rooms with out-of-network docs from network………………….

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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……………

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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.

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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

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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.

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“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.”

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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. 

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      Morning Shift Arriving At Work

One in three workers reported using prescription pain relievers — the majority under treatment of a physician………………………

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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?

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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.

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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.

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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.

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McAllen Independent School District (the “District”) invites your submittal on: RFP No. 2018-200 – Fully Insured Dental Plan…………………….

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The TRS ActiveCare plan for Texas school districts is imploding. Many want out of the program…….

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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%.

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“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.”

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Dr. Dave opines again on Medicare supplemental insurance policies…………….

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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…………………

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Hospital demands almost 2,000% of Medicare to settle claim………………….

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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………..….

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Activated immune cells travel throughout the body, killing tumors wherever they find them…………….…

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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!

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Creating electronic movement of healthcare data and money faster than a melting Raspa …………..

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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.

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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.

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Jeanne Pinder scores big with TED talk…………………….

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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.

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Insulin manufacturers and PBMs have faced mounting pressure amid outrage over the rising cost of insulin, a nearly century old lifesaving drug.

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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.

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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.

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Stringent government control of health care continues to defeat efforts of free market proponents……………….

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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……………..

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