My house burned: here’s what I learned about insurance……………
Continue reading Here’s What I Learned About InsuranceDay: January 15, 2025
Another Truth Bomb By Rojas

By Dutch Rojas
A self-funded health plan for more than 150 employees has less risk than a fully insured plan.
Continue reading Another Truth Bomb By RojasBrick & Mortar Direct Primary Care vs Virtual DPC

I’ve interviewed a number of direct primary care (DPC) organizations and asked each what their virtual engagement rate was vs brick & mortar appointments. Virtual visits run from 60 to 90%. of total visits.
Continue reading Brick & Mortar Direct Primary Care vs Virtual DPCFederal Trade Commission Report On Specialty Generic Drugs Will Curl Your Toenails

“A Growing Profit Center for Vertically Integrated Pharmacy Benefit Managers”
“The Big 3 PBMs’ affiliated pharmacies generated significant and growing levels of revenue in excess of estimated acquisition cost (NADAC) on the most highly marked up specialty generic drugs…………… the Big 3 PBMs also appeared to take in significant income from spread pricing………….plan sponsors in particular should be aware that they and their members are paying the Big 3 PBMs and their affiliated pharmacies very significant markups over the acquisition costs for critical medications.”
Continue reading Federal Trade Commission Report On Specialty Generic Drugs Will Curl Your ToenailsWill Someone Please Help Texas School Teachers?

The Texas legislature is now in session to consider hundreds of bills filed for various wish lists driven by vested interests.
Continue reading Will Someone Please Help Texas School Teachers?The Difference That Makes A Difference

Abrogating the often repeated “We take care of our employees” brain dead BUCA heath plan sponsors reduce claim costs by paying less while plan members pay more.
Continue reading The Difference That Makes A Difference