Archive for August, 2022

Plan Document Language That Makes Sense

Monday, August 15th, 2022

Plan sponsors provide employees “health care expense accounts.” This is called health insurance. Like most company expense accounts there are stipulations employees must abide by.

(more…)

The Patient Will See You Now!

Sunday, August 14th, 2022

At Revive, we have a saying: “The patient will see you now.” That’s because we’ve created a solution that puts patients in charge of their care and addresses the current challenges of the health care system.

(more…)

5 Reasons Virtual Primary Care Is Going Viral

Sunday, August 14th, 2022

As a physician, I agree with the majority of my peers who expect virtual primary care to surpass in-person care within five years…………………….

(more…)

Another BCBS Plan Buys A TPA

Sunday, August 14th, 2022

Blue Cross of Alabama has been buying up small regional TPA’s and rebranding under the name 90 Degrees Benefits. Blue Cross of North Carolina owns a TPA too. Now we see more BCBS plans entering the TPA market. Here’s the latest……

(more…)

Another Entrant Into The Level Funded Market

Sunday, August 14th, 2022
There’s More Than One Way To Skin A Cat!

Level Funded Stop Loss insurance provides all the benefits of self-funding by retaining all unused funds, lower maximum costs, no lasers, and flexibility in plan design.

(more…)

DPC + 501r = Almost Free Health Care

Saturday, August 13th, 2022

By Doug Aldeen – ERISA Healthcare Attorney and General Counsel

95 million American earn less than $35,612 or 275 percent of the FPL. Why pay for anything other than DPC with a 501 r wrap?

(more…)

South Texas Insurance Broker Is Abnormal

Friday, August 12th, 2022

Alex Zuniga is an independent insurance broker / consultant in deep South Texas who doesn’t fit the mold. He’s different.

(more…)

Come & Get Your Copiers

Friday, August 12th, 2022
Copy Machine Salesman Responds

“Come and get your copiers” says the City Manager. “But we have a five year contract!” says the vendor. “Doesn’t matter” says City Manager ……………………

(more…)

Cano Health Direct Primary Care

Friday, August 12th, 2022

Our friendly drivers will pick you up, take you to your appointment, and then bring you back home – all in the comfort of our specialized vehicles. And we will deliver your prescriptions to your home at no cost to you.

(more…)

Radion Health

Friday, August 12th, 2022

Level funded health plans are becoming a viable option to fully-insured plans. Radion Health has all the right selling buttons………………………..

(more…)

Holy Smoke – Group Health Plan To Add 87,000 Employees

Thursday, August 11th, 2022

The economy must be thriving these days. Business must be booming. The nation’s largest employer whose revenue this coming year will break all previous records will be adding 87,000 new employees to their health plan.

(more…)

DPC Outlaw Comes To Town

Thursday, August 11th, 2022
Patients Spending Quality Time At The Doctor’s Office

Remember Xerox? How about Eastman Kodak? Both were pioneers in their industries. They were visionaries providing solutions by fulfilling previously unmet needs, creating new markets that did not exist before. Now we are seeing something similar in health care……………….

(more…)

868 Wasteful Drugs

Wednesday, August 10th, 2022
(more…)

You Are Required To Know – It’s The Law

Wednesday, August 10th, 2022

By Patrick Moore on linkedin

If you’re a CFO or HR expert then you really need to hear me on this: You are now required to know how much money people are making off of your healthcare budget.

(more…)

Are You A Genius? Try This To Find Out

Tuesday, August 9th, 2022
(more…)

WOW!

Tuesday, August 9th, 2022

Comprehensive
healthcare benefits with
nationwide access

We bring you transparent access with direct-pay medical providers who get paid at the time of service so the patient is not billed afterwards! Our comprehensive network of doctors, dentists, pharmacies, labs, and everything in between for a truly complete healthcare package.

(more…)

Size Doesn’t Matter

Monday, August 8th, 2022

Everyone thinks size matters when purchasing employer sponsored medical insurance. It doesn’t

(more…)

Ruben Edelstein

Sunday, August 7th, 2022

By Bill Rusteberg

Ruben Edelstein practiced managed care in his own way. The son of immigrants, he ran a successful furniture business in South Texas. An astute businessman, he grew the business with locations throughout the Lower Rio Grande Valley in deep South Texas.

(more…)

Marpai To Acquire Maestro Health

Sunday, August 7th, 2022

First there was Continental Benefits. Then there was Marpai. Now there is……………………..

Marpai To Acquire Maestro Health

MyHealthGuide Source: PRNewswire, 8/4/2022

NEW YORK — Marpai, Inc., an AI-technology company transforming the $22 billion TPA market supporting self-funded employer health plans, announced it has signed a definitive agreement to acquire Maestro Health (“Maestro”), a leading TPA servicing over 80 self-insured employers, based in Chicago, Illinois. 

(more…)

Fully-Insured Rx Plans

Sunday, August 7th, 2022

A carved out custom fully insured prescription drug benefit plans for the large group health benefits marketplace? This is interesting. Will this lower the cost of drugs?

(more…)

Death Claims Rise 40%

Sunday, August 7th, 2022
(more…)

N. Korean Hospital Pre-Certification Program

Sunday, August 7th, 2022

In the N. Korean model, patients play an important role in the “pre-certification process” which is tied to a per admission “deductible” intended to speed up access to needed healthcare……………………

(more…)

Aldeen’s Sunday Morning Bathroom Read

Sunday, August 7th, 2022

By Doug Aldeen

Sunday morning bathroom read (Deep Thoughts by Jack Handy “SNL” edition):

(more…)

We Have A Problem With Fat People

Saturday, August 6th, 2022

“We’ve gone from fat acceptance to fat celebration. To view letting yourself go as a point of pride? The term body positivity is used to mean ‘I’m perfect the way I am because I’m me.’ It’s Orwellian.” – Bill Maher

(more…)

Legacy Health Insurance Brokers Are Bad For Your Health

Saturday, August 6th, 2022
Spreadsheet Sam Busy At Work

Legacy health insurance brokers are worthless. They’re bad for your financial health. They’re lazy, dumb and often great golfers.

(more…)

City of Raymondville Seeks Competitive Health Insurance

Friday, August 5th, 2022

Here’s an opportunity for health insurance brokers to earn big bucks by simply forwarding this RFP to the four or five remaining fully insured carriers active in the market. Effortlessly, lift your index finger, gently tap the send button, and email the link below to your favorite BUCA rep. They’ll do the work while you play.

(more…)

The Full-Risk Capitation Model: Why Make the Change?

Friday, August 5th, 2022

By Christopher Chen, MD

Consider a typical primary care doctor who sees 30 patients a day, generating some $600,000 in a year ………………………..

(more…)

It’s time to expose the secret drug scam at the heart of American health care

Thursday, August 4th, 2022

BYHOWARD DEAN

July 26, 2022 at 4:47 AM CDT

In 2021 alone, pharmaceutical firms provided a staggering $204 billion in price concessions for brand-name medicines–but the funds have mostly benefited insurers and their pharmacy benefits managers.

A federal court recently exposed the rot at the heart of America’s health care system.

(more…)

The Primary Care Gold Rush

Wednesday, August 3rd, 2022

Retailers, payers and startups could capture 30% of primary care market by 2030: report

By Heather LandiAug 2, 2022 12:30pm

Bringing new care and reimbursement models to the market along with a bigger focus on virtual care, these nontraditional players are gaining traction and have the potential to grab as much as a third of the U.S. primary care market by 2030, according to a new report from Bain and Company.

(more…)

Revive Health Expands Growth Trajectory

Wednesday, August 3rd, 2022
ReviveHealth

Emerging Leader Accelerates Growth Trajectory and Market Penetration

PONTE VEDRA BEACH, FL / ACCESSWIRE / August 3, 2022 / ReviveHealth™, Inc. has announced they have acquired ManifestRx™, an innovative national digital pharmacy services platform, as they continue their quest to become a preeminent leader in digital health whole-person care.

(more…)

How Would You Deal With An Unexpected $1,908 Hospital Bill?

Tuesday, August 2nd, 2022

The parents of Maddux Brown saved big when they learned that nonprofit hospitals are required to provide financial assistance. You and your loved ones could, too!

By Marshall Allen

When 6-year-old Maddux Brown underwent a 15-minute surgical procedure his dad Jason didn’t expect the bill to empty his bank account. 

(more…)

How To Secure Good PBM Contract Terms

Tuesday, August 2nd, 2022

“If your PBM contract pricing includes AWP-X% you are getting screwed. If the contract also includes MAC pricing you’re getting doubly screwed” – Molly Mulebriar

(more…)

“Abusive” Blog Reinstated

Monday, August 1st, 2022

RiskManagers Blog has been down the last few days with readers getting the message “Access is not available on account of abusive activity.”

(more…)

PE-backed Zelis buys Spectrum’s Payer Compass

Monday, August 1st, 2022

By Sarah Pringle

Zelis Healthcare, backed by Parthenon Capital and Bain Capital, has agreed to acquire Payer Compass for roughly $180 million, sources familiar with the matter tell Axios.

Go deeper (2 min. read)

800 Life Case Seeks Health Insurance Proposals

Monday, August 1st, 2022

This 800 pound gorilla is located in deep South Texas, in the Lower Rio Grande Valley.

(more…)