Shared Perceptions: Yellow Cab, Kodak, General Motors, Borders & U.S. Health Care

yellowcabAsk most Americans about obtaining their health care outside of the United States, and they respond with disdain and negativity……. Of course, that’s exactly what Yellow Cab thought about Uber, Kodak thought about digital photography, General Motors thought about Toyota and Borders thought about Amazon. 

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There Is A Proper Way To Repeal Obamacare

alanpreston Dr. Alan Preston

Revamped health savings accounts, portable employee plans would ease financial burden on consumers

By Alan Preston, For the Express-News January 21, 2017

One of the campaign promises of the Trump administration is to repeal and replace the Affordable Care Act, and Congress is working on precisely that. As with most legislation, the ACA has parts that are helpful and parts that are hurtful. Some of the good or bad of the law depends on whether or not you benefit from it.

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Broker Tip of The Day

tipofdayIf the ACA individual mandate goes away, the biggest loser for insurance brokers will be MEC plans while the biggest winner will be Short Term Medical plans. MEC plans offer limited coverage and often cost up to $100 per month while Short Term Medical plans offer comprehensive coverage at similar or lower costs. Smart brokers with MEC plans on the books should be prepared to adapt to what we believe will be a transformational market in 2017.

One broker is ready to accommodate the market – www.agilehealthinsurance.com

THE HEROISM OF INCREMENTAL CARE

klepper

The following article was send to us from Brian Klepper, PhD, health care industry expert.

“We have a certain heroic expectation of how medicine works. Following the Second World War, penicillin and then a raft of other antibiotics cured the scourge of bacterial diseases that it had been thought only God could touch. New vaccines routed polio, diphtheria, rubella, and measles. Surgeons opened the heart, transplanted organs, and removed once inoperable tumors. Heart attacks could be stopped; cancers could be cured. A single generation experienced a transformation in the treatment of human illness as no generation had before. It was like discovering that water could put out fire. We built our health-care system, accordingly, to deploy firefighters. Doctors became saviors.”

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What Is The Actual Cost Of An Employee’s Doctor Visit?

cost1111There is a lot of discussion about the costs of healthcare, both for users and their employers if the employer is providing insurance.

Side Note: We have seen claim experience that document average cost of a doctor visit is $700. Yes, that’s correct, $700. This includes doctor charges, lab test, radiology, prescription drug/s. Consumers, shielded by low co-pays don’t see this, nor do they care. Four office visits in a year could eat up the premiums paid toward coverage. This is not insurance………….

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riskmanagers.logoRiskManagers.us is a specialty company in the benefits market that, while not an insurance company, works directly with health entities, medical providers, and businesses to identify and develop cost effective benefits packages, emphasizing transparency and fairness in direct reimbursement compensation methods.

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Are PPO Networks the Worst Negotiators in the World?

unlockppo“An industry insider shared an example that I’ll anonymize. An analysis was done for a school district and one of the things looked at was where lab tests were done. This school district had nearly 1,500 metabolic profiles in the measurement period and paid well over $200,000 when they should have only paid under $10,000. Direct contracting/cash prices averaged 96% less in their market. That’s an average of $150 a test for what should be a $7 test.”

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Employers May Adopt ‘Narrow Networks’ of Health Care Providers

confused“There are signs that employers’ interest in narrow networks may grow in the near future.”  But that is problematic. Why limit choice of providers when you can simply pay all providers the same? That solves access and financial issues for plan sponsors where the difference between profit and loss many times is tied to health care costs. Isn’t it about time consumers realize they are helping to drive costs up by accepting terms and conditions set by insurance companies and complicit plan sponsors too dumb to realize the implication of good intentions (providing employee health insurance) is having a reverse effect on their bottom line? – Signed: Ranting and Raving (Name held upon request).

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