“Drug prices are out of control, and Big Pharma continues to raise the prices for all Americans……….Not only does that mean higher prices at the pharmacy counter, it also means higher premiums and other healthcare costs for everyone.”
After satisfying their initial waiting period averaging 47 years, approximately 30% of the American workforce is eligible for special health care pricing while the remaining 70% aren’t. Paying for it during their entire waiting period, they deserve better pricing………………..
Emergency room physicians (and their anesthesiologist cousins) are a different breed. They don’t often join managed care networks. They serve a captive audience. The only emergency room door exit is to the billing department. They charge an arm and a leg. They are the Balance Bill Kings of Health Care because they almost always do and never, almost never, ever, negotiate. But that’s about to change in Texas………………unless your’e insured through an Arm & A Leg Plan (self-insured plan).
The creator of The Schuessler Stick™, Carl Schuessler explains his success in building a rural community health care plan while freezing his ass off in a Georgia deer blind. Listen to Carl starting at 8:00 – 20:30.
Texas school districts enrolled in TRS ActiveCare have not had competitive options available to them until now. No matter how large a risk pool is, economies of scale doesn’t matter when risk management systemically fails to adopt proven strategies in a dynamic and changing market.
“We have budgeted $2 million for our employee health insurance plan. Build me a plan for my 350 employees that doesn’t cost a penny more than that!” was the directive from the CEO, a Type A personality who doesn’t take “no” for an answer and expects results even if impossible. So we did……………..
“It is a common misconception that clients are entitled to receive any data, at any time, simply by virtue of being self-insured and having elected to receive Protected Health Information (PHI). This is not the case…….”
High deductibles are road blocks to needed health care and do nothing to impact health care costs. Smart employers are discovering they can improve benefits and lower costs at the same time. The following article referred by Dan Meylan describes the problem we all face to these man made barriers to health care……………..
Dr. Rebecca is passionate about providing holistic primary care to families. She understands that healthcare is expensive, which is why she is starting her practice with an innovative new model called “Direct Primary Care.”
From: Bill Smith, President, Cigna Group Insurance [mailto:email@example.com] Sent: Wednesday, December 18, 2019 12:03 PM To: Subject: Important news from Bill Smith, President, Cigna Group Insurance
David John Rendall
March 19, 1937 – January 1, 2020
David used his marketing skills and passion for deal making to start several healthcare related businesses that have evolved into a large enterprise, which currently has operations in 4 continents and clients in over 80 countries.
“The emergence of biologics and gene specific medications will serve to drive these increases further as we move forward, as evidenced by Zolgensma (treats Spinal Muscular Atrophy) at an estimated $2.1 million and Luxturna (gene therapy for a retinal disease) at an estimated $850,000.”
Timing is everything when it comes to new and innovative ideas in health care delivery as the market must be ready and receptive. In 2005 it wasn’t……………..But two years later it slowly took hold in Texas…………And we were ready.
“Health-plan participants could conceivably choose to challenge health-plan fees with general fiduciary-breach claims. In fact, it is reasonable to expect that such claims will be made against other health-plan sponsors, given that plaintiffs’ firms have begun to solicit potential class representatives and request health-plan fee information from employers.”
Health care is a business like any other, and it can follow good business principles. Like other industries it can benefit from bottom-up innovation by entrepreneurs and intrapreneurs, rather than rely solely on top-down reforms coming out of Washington, DC. That’s what this book is about.
If this passes it will have a profound effect on the future of employer sponsored health plans………no longer held hostage to jobs they hate but need for health care benefits, plan members will be able to control their own health care benefit decisions………..