Registration is now underway for Summer Session 2022, A Public Purchasing Seminar! Join ISM-RGV at South Padre Island, June 22, 23, 24, 2022……Learn about public purchasing laws affecting you and your entity.
Registration is now underway for Summer Session 2022, A Public Purchasing Seminar! Join ISM-RGV at South Padre Island, June 22, 23, 24, 2022……Learn about public purchasing laws affecting you and your entity.
Doctor Working Under Pandemic Stress Pressures
“Experts” warn that the man-made Chinese Flu pandemic, now entering its third year, has pushed primary care workforce towards rapid extinction……..20% of primary care physicians intend to quit………..the rest are being swallowed up by the hospital industrial complex at a rapid rate…………
Miracle Mike Before His Transformation
Most plan sponsors are chickens, too afraid to step away from status quo health care strategies that don’t work and never will. They all share common roots according to historians.
When a self-insured plan sponsor doesn’t audit weekly claim check runs bad things can happen………….
Continue reading CFO Rakes In Big Bucks + Gets Free Food & Lodging For 5 Years
By Bill Rusteberg
A Texas state government health plan established 20 years ago as a solution to rising health care costs incorporates a legacy, status quo managed care approach that hasn’t changed since it started.
Continue reading Texas Legislature Gifts Back Local Control of Health Care
MAY 12-14, OMNI FORT WORTH HOTEL, FORT WORTH, TEXAS
JOIN US MAY 12-14 FOR THE EVENT DEDICATED TO DIRECT CARE STRATEGIES AND ADOPTING FREE MARKET PRINCIPLES IN HEALTHCARE.
Continue reading DON’T MISS THE FMMA 2022 ANNUAL CONFERENCE!
“After encountering pushback from insurers and claims administrators, out of network providers have sued to recover reimbursement for thousands of claims, primarily arguing that the CARES Act provides them with a private cause of action for reimbursement at the at ‘cash price’ they listed on their websites.
Continue reading Employers and Providers Fight Over COVID-19 Testing Costs
Millions of dollars in questionable expenses, a generous administrative payroll, high executive turnover and rising health care prices……………Unlike health insurance companies, which are subject to regulation, the trust does not answer to the Department of Insurance. For years, there have been complaints of impropriety, and expenditures have been hidden from public scrutiny……
Continue reading Public School District Health Insurance Trust In Big Trouble
Travel agents and stockbrokers are nearly gone the way of the dinosaurs and so will PPO networks and status quo benefits brokers………………….
Continue reading What Do PPO’s and Dinosaurs Have In Common?
In a testament to the power of science, and beer — researchers in Switzerland outfitted a 36-year-old ALS patient with a chip in his brain, which allows him to spell out sentences one letter at a time, and he used it to order up a cold one.
By Eric Bricker
Google Announced It is Creating a New Healthcare Stop-Loss Company Called Coefficient. Coefficient Will be a Part of the Verily Healthcare Subsidiary Within Google.
“Double your pleasure, double your fun with double mint, double mint, double mint gun.”
NEWEST VERSION: Double your pleasure double your fun with the best double priced discounts found under the sun …………….Hurry buy our health insurance and get a 50% discount off double the price! Call now and talk to one of our licensed agents, plus get your free gift – only good for the first 25 callers! Hurry…………………….Call 867-5309 and ask for Jenny
Continue reading Double Your Pleasure, Double Your Fun…..Call 867-5309 Now!
A leading provider of Reference Based Pricing…….oops, I mean Workers Compensation Insurance which is a Reference Based Pricing health care payment strategy…………..
PBMs: The “Tapeworm” Revealed
How is it that the process of distributing a drug and tracking who buys it sucks up much more of the value chain than actually making it?
By Bill Rusteberg
In 1982, after nine years of corporate servitude, I left the inner sanctums of a large health insurance company and the comfort of receiving a corporate paycheck every two weeks whether I earned it or not.
Continue reading Feeding Brokers At The Expense of Starving Ones
By Bill Rusteberg
“Playing” health insurance brokers is the easiest sale ever. I was reminded of that today when a company rep. said “Bill, I never call on a prospect directly, I always work through the broker on the case. It’s the easiest sale ever. I don’t have to cultivate a relationship with the client. That can take years. It’s already been done by the current broker.”
J. Patrick Rooney is considered by many to be the Father of Margin Based Pricing better known these days as Reference Based Pricing. Many believe his conclusion of what the “sweet spot” reference point should be still holds true today.
Associate Superintendent of Human Capital and Operations Anthony Sorola and Medical Plan Consultant Eric Smith listen as Director of Benefits & Risk Management Yolanda Gordon talks about the newly opened ECISD Wellness Center. (Ruth Campbell | Odessa American)
Continue reading West Texas School District Opens On-site Clinic
You Can Always Count On Aldeen’s Weekly Bathroom Read Series Which Has Never Missed A Deadline Even In The Hardest Of Times………We Can’t Wait For The Easter Edition…….
Continue reading Weekend bathroom read (Spring Break/Hangover Edition)
“For 2021, the NET prices for brand-name drugs dropped – for the FOURTH consecutive year…….” Lantus, an insulin drug, has fallen 62% since 2012 but costs for patients with health insurance who use Lantus have GONE UP by 60% over the same period.”
Global reinsurance giant Swiss Re has reportedly decided to cease taking on new business with clients in both Russia and Belarus amid the ongoing invasion of Ukraine, according to Reuters.
How will each regional service center identify and analyze three alternative health care options within their region?
Continue reading Texas Legislature Wants School Districts To Assess Health Coverage Options
A San Antonio brokerage firm touts their success in helping a San Antonio school district reduce their medical spend by 40% by implementing ……….Drum Roll Please………..A wellness plan. We find this hard to believe.
“Pssst Godfather….We Need To Get In The Drug Business!” We can make a lot of money in rebates…….I mean kickbacks. And we can open specialty pharmacies and skim off the float too and call it spread pricing or shrinkage……………We can call ourselves Pharmacy Benefit Managers……..Has a nice ring to it……………..We can make some really serious money Godfather!”
A hospital in Munich, Germany sent this letter where they announce that “from now on and until further notice, we will not treat Russian and Belarusian citizens.”
Continue reading German Hospital Refuses To Treat Russians or Belarusions
By Bill Rusteberg
White Flag plan sponsors are those employers who cower to the Great American Health Care Industrial complex, willingly prostrating themselves to continued abuse at the hands of hospital administrators, insurance companies and a host of third party intermediaries.
Continue reading White Flag Plan Sponsors Need An Intervention
Dear Valued Employees, we are pleased to announce we have added medical expenses to your company provided expense account effective immediately………..
Continue reading Good News! Your Company Expense Account Now Includes Medical Expenses!
Mark your calendar – Continue your education here…………………
Continue reading Advanced Health Care Studies 401 – New Group Requirements Under The CAA
Hermann Ebinghaus
How effective are employee health insurance benefit meetings? Or are they a waste of time?
With little formal training, a majority of health insurance brokers back in the day were simply spreadsheet artists………………………….
Continue reading Managing Risk vs Servicing Risk – The End of Status Quo Brokers?
By Marissa Plescia
Five medical bills have made headlines in the last few months, including a $13,000 one for a kidney donation and a $847 “facility fee” for a telehealth visit.
Self-funded plans need to check their administrative services agreements to see exactly how much responsibility they might bear for decision-making…. Who will make decisions and represent the plan when it comes to arbitration? Will it be Tom, Dick or Harry?
Continue reading NSA – Whose Responsibility? Who Makes The Decisions ?
“For 2022, many TPAs are subjecting NSA claims to their ‘shared savings’ and similar programs, which could result in unexpectedly large fees….
C2C Choice Rx provides patient concierge and advocacy services………….. With our patient assistance program, you will typically get your medication for free.
“I Call The Plan Fiduciary To The Stand!”
Whether they like it or not plan sponsors must now understand they are in the health insurance business……
Continue reading Why a ‘Tidal Wave’ of Fiduciary Lawsuits Are Coming Soon
Yale University reached a nearly $1.3 million settlement with workers who say a rule requiring them to participate in a wellness program or pay a fee violated federal disability bias and genetic information laws, Connecticut federal court records show.
Continue reading Yale Reaches $1.3 Million Deal in Wellness Plan Bias Suit
This report briefly summarizes each kind of HRA, highlighting key aspects regarding eligibility and insurance coverage requirements, contributions, distributions, and the treatment of unused balances for each arrangement. It also provides a side- by-side comparison table of the different kinds of HRAs.
“How Sweet It Is!”
Doctors say a young boy called Easton has made medical history by becoming the first person in the world to receive a combined heart and thymus transplant.
Dr. Joseph Fraiman: “Personally, I would like to apologize to the three other scientists sitting with me here on Zoom, the proponents of the Great Barrington Declaration…I’m sorry, because I believe now you guys were correct. And you were correct from the beginning.”
“Eighteen-year-old high school student Edger Mulili says he would not be alive today if his father had not contributed $5 a month to a government health insurance scheme.”
Continue reading National Hospital Insurance Fund (NHIF) Saves Edger’s Life
“Thank You Consolidated Appropriations Act, 2021!”
“The motherlode for the plaintiffs’ bar however is in the broker/consultant compensation disclosure rules. For starters, there is the obvious claim that the rule was not properly followed, thereby triggering a prohibited transaction. Equally obvious and even more worrisome, however, are claims that are right out of the 401(k) litigation playbook: the plan paid excessive fees and plan fiduciaries were not paying attention. Essentially, the statute’s focus on fee disclosure invites scrutiny of the underlying fees and the accompanying fiduciary engagement.”
Continue reading Lawyers, Spiders, Snakes and Other Scary Things
What if you could buy healthcare like you buy anything else? If you know you need a knee replacement, imagine going to a website, picking an operation, and seeing the price, just like you do on Amazon or McDonald’s……………………..
Continue reading Welcome Sir. Here’s Our Menu. May I Get Your Drink Order While You Decide?
Ever wonder why your provider asks if you have “other insurance……………”
Continue reading Insights on How Insurance Companies Handle Medical Claims
Thinking Outside The Box
“Hue builds health plans around the concept of advanced primary care as the center of all patient care coordination–a “healthcare quarterback.” Their highly scalable, value-based network approach enables providers to focus on practicing medicine how they see fit based on what their communities need, spending dramatically less time on billing and administrative services.”
Continue reading Replacing Traditional TPA’s With Next Generation Health Plans
This is another great video by Eric Bricker. But he may have missed one other important quality in banging a deal together for the home office……………….
Today, doctors and teachers are exiting entrenched institutions and building exciting, new models that offer greater freedom and flexibility for all.
Continue reading Bye-Bye Bureaucracy & Burnout: Teachers and Doctors Build New Alternatives
Dental assistant Atkins trained to calm uptight patients without slobbering………….
Continue reading Snuggle Ready Dogs Join Health Care Provider Community
The federal government pays the employer a set amount for each person in the plan……..
Continue reading Hallelujah! Group Retiree Health Plans Discover Found Money!
Sold policies to more than 400,000 individuals across America over the phone…..
Continue reading How Steven Dorfman & Friends Made A Fortune Dialing-For-Dollars