Article Referred by Doug Aldeen
December 15, 2021 at 11:02 am PSTBy Jesse Jones, KIRO 7 News
OLYMPIA, Wash. — Charity care is a necessity for families all over the state and hospitals have written off hundreds of millions of dollars of care to those in need, keeping them from suffering crushing medical debt.
Industry trade groups believe big government can solve health care because they can’t. They are begging for help. There is a way the private sector can solve health care but plan sponsors would have to break the law in order to do so. So we need more laws………… (more…)
Risk Strategies (www.risk-strategies.com) is a specialty national insurance brokerage and risk management firm offering comprehensive risk management advice and insurance and reinsurance placement for property & casualty, and employee benefits risks.
Is your plan a hospital controlled process or a plan sponsor controlled process?
Indiana’s largest hospital system has announced it will reduce their hospital prices. A Rand Corporation study has found that Indiana hospitals charge on average three times what Medicare does…………………”A 2020 Rand study found that IU Health prices between 2016-2018 ran 33% higher than the national average.”
“With the launch of this service, Hy-Vee joins the current trend of retailers investing in telehealth and remote patient monitoring technologies.”
By Bill Rusteberg
The 1980’s and early 1990’s were the Golden Years for brokers active in the group health insurance market.
TRS Board Member Reacts To The News
For the first time in 20 years TRS ActiveCare member school districts may leave the government health plan provided they give notice of intent to leave by December 31, 2021.
“Using Amazon Care, we were able to connect with a clinician in under a minute who provided medical advice that helped us get through the night. She also prescribed a medication that was delivered to our doorstep by 9 a.m. the next day”
This health plan is an expense account funded by your employer.
“When you go out of town on company business and have to stay overnight we will pay for your hotel room. The expense account limit is $150 per night so if you decide to stay at the Ritz Gold Star Hotel you will have to pay the difference” explains Sally in accounting.
It’s all about the margin………………………….
A Texas school district was interested in learning why their health insurance costs increased dramatically when they changed their plan administration from Blue Cross to an independent TPA.
Virtual care in particular has seen a bump during the pandemic, as in-person services were limited if available at all.
Under the NO SURPRISES ACT if there is a payment dispute (balance billing) from a provider, the health plan is required to participate in a third-party, unbiased arbitration process to establish a qualifying payment amount (QPA) for similar services in a geographic area.
Findings are based on a survey of 600 U.S.-based HR professionals who are directly involved in managing their company’s health insurance
72% of respondents said their organization is considering switching its healthcare insurer or plan administrator in 2022 — signaling a level of dissatisfaction and disengagement across the industry.
Eagle Pass Independent School District has got to be paying more for health insurance than any other school district in Texas…………………..
SOURCE: Multiplan
This Q&A should give a degree of comfort to those worried about the impact the No Surprise Act will have on Reference Based Pricing plans. However, one must always consider the source when coming to one’s own conclusions.
By Molly Mulebriar
In one of the most far reaching edicts issued by Congress and promulgated by faceless bureaucrats in Washington, the American health care delivery system is about to enter a new era bringing fundamental change to the way health care is financed and delivered in this country.
As the deadline approaches for Texas school districts to decide whether to continue TRS ActiveCare membership we see more competitors vying for the business.
Nothing like a good dose of competition these days. Now, for the first time in over 20 years, Texas school districts have government permission to exit the program. Intense, pent-up competition is hell bent on peeling off as many districts as possible from the government health plan with the potential of earning millions.
How to Promote Health,
Decrease Costs, and Lower Premiums
A company’s healthcare costs increase due to unrestricted access to the typical network of hospitals and hospital-owned physicians who are incentivized to perform more procedures and order more referral to specialists.
The new Surprise Billing and Transparency rules to take effect in 2022 will be a game changer for Reference Based Pricing plans. Add to that the upcoming 10% Medicare cut to physicians.
THE HOT POTATO RISK TRANSFER METHOD
Hot Potato Health Plans are a growing market phenomenon. These plans have found a solution to high-cost specialty drugs through a common sense risk transfer method.
“You won’t believe what they are going to talk about………….”
TRS: Notice of Webcasts – Dec. 7-8 Board Meeting
We’d like to inform you of our next board meeting webcast on Dec. 7-8, 2021. The board meeting will begin at 8 a.m.
“Unknown to the School Board, Gallagher had received secret insurance commissions over the years totaling millions of dollars.”
“United’s Shared Savings Program takes up to a 50% administrative fee on the difference between billed charges and United’s arbitrary payments. United often receives more money on their shared savings fee than they pay to the provider.”
So, what else is new? This happens all the time. Most plan sponsors don’t know anything about this. Here is another example, Aetna’s shared savings of +9% (Weslaco ISD vs Aetna) And how about Oakland County vs BCBS? Cigna vs Anheiser Busch? There are hundreds of lawsuits over the years addressing this practice. – Bill Rusteberg
Doctors Warn New Medical School Guidance Would Lead to Unqualified Physicians and Unscientific Medicine
Accreditation guidelines call meritocracy ‘malignant,’ suggest genetic screening is racist
