Archive for July, 2018

In Health Care The Law of Supply & Demand Doesn’t Exist

Sunday, July 15th, 2018

The law of supply and demand doesn’t apply to health care. Lower demand means higher cost.

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I Will Show You How To Cut Your Rx Costs by 50%

Saturday, July 14th, 2018
I’m talking perception vs. reality on our next Expert Session, 7/17. The Pharma industry lobbies for big box PBMs and if you think you’re in good hands, consider this your wake up call…………….

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The Ever Outrageous Outlier

Friday, July 13th, 2018

This one (lawsuit) appears to be all about outlier provisions, and what happens when a really high dollar claim hits a plan………………………………..

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Paychex Now a ‘Top 20’ Insurance Agency in the U.S.

Friday, July 13th, 2018

Paychex ranks as one of the fastest-growing firms in the nation…………………….

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A New Twist in Reference Based Pricing Lawsuits?

Thursday, July 12th, 2018

“And the verdict is…………….”

This case is instructive for employers who use reference pricing.  It is a good reminder that employers who use reference pricing should confirm that they fall within the guidance for establishing a network and confirm that their administrators are correctly explaining the plan terms to providers who call to determine coverage.

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Mike Dendy Announces Launch of AHPA

Thursday, July 12th, 2018

I’m pleased to announce the launch of Association Health Plans of America (AHPA).  AHPA will be sponsored by Job Creators Network (JCN) an Association started by Home Depot founder Bernie Marcus to assist small businesses.  JCN has partnered with Dr. Tom Price former Secretary of HHS and the primary author of the AHP regulations and legendary business and sports legend Fran Tarkenton for the development and national deployment of an AHP targeting small employers and using the new regulations to place the group(s) upon an ERISA self-funded platform.

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Health Care Expert Poses Interesting Question

Thursday, July 12th, 2018

By Mel Schlesinger

Editor: Another interesting observation by Mel Schlesinger: Lower your health care costs by enrolling for a 3 credit hour course at your local college………………………………

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New Cost Containment Strategy? – DIVORCE

Thursday, July 12th, 2018

The following article is another example of a broken health care system and the lengths some take to find affordable health care…………………..

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TPA Sues Teladoc

Thursday, July 12th, 2018

An Illinois benefits administrator is suing the telemedicine company Teladoc for $450,000 in overcharges, claiming the company tried to restructure a refund to avoid a negative outlook on its financial statements.

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One Phone Call Later And Presto – Lower Rx Prices for All Americans

Wednesday, July 11th, 2018

“Just talked with Pfizer CEO and @SecAzar on our drug pricing blueprint,” Trump tweeted Tuesday night after arriving in Brussels, Belgium, for the NATO summit. “Pfizer is rolling back price hikes, so American patients don’t pay more.”

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Scheussler Stick™ Sales Explode

Tuesday, July 10th, 2018

The Schuessler Stick™, introduced to the market less than one week ago, is surpassing all sales expectations. It’s rumored to be a “must have” for all the attendees of the upcoming SIIA convention in Austin, Texas. Orders are averaging 2,000 per day.

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The 340B Program

Tuesday, July 10th, 2018

For 25 years, the 340B program has provided hospitals with financial help to expand access to life-saving prescription drugs and comprehensive health care services to low-income and uninsured individuals in communities across the country.

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Getting Away With Murder

Tuesday, July 10th, 2018

“Pfizer & others should be ashamed that they have raised drug prices for no reason,” Trump posted on Twitter. “They are merely taking advantage of the poor & others unable to defend themselves, while at the same time giving bargain basement prices to other countries in Europe & elsewhere. We will respond!”

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Detecting Truth, Deception, and Lies

Tuesday, July 10th, 2018

Most people believe they can tell when someone is lying…………….but some can’t. For example, an insurance agent representing a BUCA tells their client they receive no other compensation other than the disclosed PEPM fee. How can one tell if this is a lie………………?

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Let’s Face It – Scott Sterling Never Gives Up

Monday, July 9th, 2018

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David Belk Reports On His RX Findings

Monday, July 9th, 2018

David Belk, M.D.

Hello again everyone, I hope you all had a great 4th of July!

I’m writing you all today to give you two updates about prescription medication costs. The first update has to do with the cost of generic prescription drugs: Their prices went down last year! That’s right, down, by an average of about 12%!!

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The Path To Fixing Health Care Starts With Employers

Sunday, July 8th, 2018

“You don’t need an act of Congress to make a difference when it comes to employer health” – Dave Chase

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The Schuessler Stick™

Saturday, July 7th, 2018

“I always say I have to carry metal rod with the mirror at the bottom of it to run under my car before crank it up”Carl Schuessler

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Benefits Consultants Group

Saturday, July 7th, 2018

Delivering comprehensive resources to the advisor community…………………….

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Is Anything But Status Quo Better?

Tuesday, July 3rd, 2018

When things are so bad that anything different than the status quo is considered a good idea…that’s when we find out just how bad it really can get.

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Who Starts Tyrone’s Car In The Morning?

Tuesday, July 3rd, 2018

How many businesses do you know want to cut their revenues in half? That’s why traditional pharmacy benefit managers don’t offer a fiduciary standard and instead opt for hidden cash flow opportunities such as rebate masking. Want to learn more? – Tyrone Squires

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Managing Risk VS Servicing Risk

Tuesday, July 3rd, 2018

Brokers who survive in the long run will adopt both strategies by aggregating best in class services on a private label basis as a single source comprehensive branded model……………………..This will enable independent brokers to effectively compete with the big boys…………………….

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Nurse Hotline Causes Sharp Increase in ER Visits

Monday, July 2nd, 2018
One time some years ago I implemented a 24 x 7 nurse hotline for a two hundred thousand life group……..

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PillPack Founders, 32 & 35 To Receive $200 Million From Sale

Sunday, July 1st, 2018

The two co-founders of PillPack are set to get about $100 million each in the startup pharmacy’s sale to Amazon.com.

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Amazon + PillPack = Major Market Disruption

Sunday, July 1st, 2018

PillPack is an online pharmacy that packages, organizes and delivers presorted doses of medications.

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Healthcare Price Transparency Ballot Initiative

Sunday, July 1st, 2018

“We launched our advocacy program in Colorado in 2017, and drafted powerful legislation, which will serve as a prototype for our efforts in other states.” – David Silverstein

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Cost Plus Rx Reimbursement Model

Sunday, July 1st, 2018

A cost plus Rx (NADAC + dispensing fee) reimbursement model makes sense…………….

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