Archive for March, 2019

Amazing Statistic!

Thursday, March 21st, 2019

The latest survey shows that

three out of four people make

up 75% of the population

 

 

The 20 Most Expensive Drugs in the U.S.A.

Thursday, March 21st, 2019

All 20 of these drugs are priced well over $25,000 for a monthly supply, or + $300,000 per year

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Will Texas Consider Feasibility of Reference Based Pricing Strategies for Public Educators?

Wednesday, March 20th, 2019

               $64,000 Question

House Bill 3987, if passed, will direct a commission to study alternative mechanisms for offering health benefit plan coverage to the affected employees  of the TRS ActiveCare program and their dependents. Will “alternative mechanisms” include a study of Reference Based Pricing strategies? Will Texas follow the lead of Montana, North Carolina and the South Texas Health Cooperative? 

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Insurance Agent Who Stole 80+ Identities Gets Probation

Monday, March 18th, 2019

A Colorado insurance agent who created more than 80 phony life insurance policies has been sentenced to probation.

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What Health Care Consumers Never See

Friday, March 15th, 2019

I get emails like the one below almost every day on claims incurred under various Reference Based Pricing plans. The redacted email below shows how egregious health care billing practices are and what consumers are expected to pay in relationship to what Medicare pays.

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3 Drug Manufacturers Hold 7,000,000 Americans Hostage – Life or Death?

Friday, March 15th, 2019

The Canadian inventor of insulin sold his patent for $1 to the University of Toranto back in the 1920’s to benefit mankind with a life saving, inexpensive drug. Now three drug manufacturers hold the power of life and death over 7,000,000 diabetic Americans. Why?

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A Cost Effective Approach to Reference Based Pricing

Thursday, March 14th, 2019

 

 

Going with a PEPM subscription model yields greater plan savings than charging a percentage of savings. Our RBP solution, powered by Payer Compass, uses that model and helping is helping clients save up to 72% over traditional PPO networks.

Texas School District Continues Deficit Spending On Health Plan

Thursday, March 14th, 2019

The Donna Independent School District (DISD) in deep South Texas continues to under fund their self-funded health plan. In a competitive RFP process last year the district moved their self-funded health plan administration from Blue Cross to United HealthCare. However, the change in plan administrators have not shown any savings to date, although there is a “shared savings” fee paid to the administrator. Try explaining that to the boys in the domino parlor.

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New Health Plans Expose Insureds To Less Risk

Thursday, March 14th, 2019

New health plans expose insureds to less risk:

The risk of systematic rising health insurance costs, erosion of  benefits and less choice. Provider payments are fully transparent unlike traditional health plans that cloak provider pricing in secrecy.

Members may select any provider of choice unlike PPO and HMO plans. There are no high deductibles and in some cases no deductibles at all. So what’s the catch?

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Some TPA’s Are Planning For Survival, Others Are Not

Wednesday, March 13th, 2019

With a single payer system only one election away, some TPA’s are looking towards the future. Others have their heads in the sand.

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Blue Cross Enters Food Business

Wednesday, March 13th, 2019

For a low co-pay of $10 every time you order a meal and a reasonable $6 delivery charge (tips encouraged) you can get free meals from Blue Cross if you live in designated areas. You don’t even have to be a Blue Cross member, although we suspect those are the ones paying for all of this……………

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Mother Knows Best

Tuesday, March 12th, 2019

A major carrier (Mother) will require all new self-funded employer customers (Children) to incorporate this feature into their plan designs……………….As children don’t you hate to be told what to do?

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Lockton Enters Reinsurance Business

Monday, March 11th, 2019

Reinsurance is a key pillar of Lockton’s aggressive growth plan……………………..

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Monkey Business?

Monday, March 11th, 2019

1980’s BCBS Representative At Work

I remember years ago when I was a naive young salesman for BCBS working in a rural area office. I was eventually promoted to a big city office. It was a new experience for me. I noticed real fast that all the other sales reps. were involved in some sort of  “monkey business.”

They were typing up group health insurance proposals in the confines of their company paid offices (door closed of course) on behalf of competitors, pocketing commissions earned in addition to their BCBS salary. One rep. showed me his check stubs from more than one competitor and said “Bill, why don’t you do the same? It’s easy money! And, if I get fired or quit, I have a nice steady income coming in!”

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Population Health on Steroids

Monday, March 11th, 2019
Does your self-funded health plan have the latest technology required for advanced risk management purposes?

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Solving Health Care At An Affordable Price

Thursday, March 7th, 2019

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Opening The Black Box

Wednesday, March 6th, 2019

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Retail Rx Prices Vary a Lot!

Wednesday, March 6th, 2019

I take a prescription drug that costs $18 at a mom & pop pharmacy in Cuero, Texas that costs $95 at a chain pharmacy 34 miles down the road in Victoria, Texas. A pharmacist friend told me his cost is $6…………..But of course not too many people know this or care. All they see is a Rx co-pay which effectively hides the scheme from public outcry…………..Many of our clients exclude two of the largest drug store chains in the country because they know prices there are 500-600% higher at the retail level than most independent pharmacies. That alone will save on average 5-10% off a group’s total drug spend.

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Seize The Day & Reference Based Pricing

Tuesday, March 5th, 2019
One of many emails I get every week about Reference Based Pricing strategies. Seems there are more and more TPA’s entering that space in partnership with either ELAP, AMPS, Six Degrees or Payer Compass, the Big Four. Then there are all the others like HST and UCC making inroads too. Now we are seeing some of the BUCA’s entering into the Reference Based Pricing space via their wholly own TPA subsidiaries with the apparent mantra “If you can’t beat them, join them.”

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Specialty Drugs Are Killing Your Renewals!

Tuesday, March 5th, 2019

War On Drugs Continues……….

We specialize in helping self-funded employers dramatically reduce Rx spend while providing members a $0 Rx copay for many name brand and specialty meds.

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Insurer of Last Resort

Tuesday, March 5th, 2019

“No problem Joe, I’ll make a call for you”

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Glenn McLellan – Sales & Account Management at Centivo

Monday, March 4th, 2019

For 35 years I have worked closely with all constituents in the self-insurance industry to help our industry be the best that it can be. From my perspective, the development of Centivo is the culmination of every effort I have made for a TPA to be “world class” and represent the future.

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TPA Offers New Health Plan Model

Sunday, March 3rd, 2019

Centivo offers an alternative to traditional insurance carriers or third-party administrators……..

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War On Drugs – The Indians Are Restless

Sunday, March 3rd, 2019

Boston Tea Party

What’s the price of tea in China? How about insulin………….Insulin which was discovered in the 1920’s and whose patent sold for $1, has doubled in price between 2012 and 2016 while the price of insulin drug lantus increased 49% in 2014 alone. Why? In this war on drugs we should “Just Say No.”

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It’s Scary – House of Representatives or House of Horrors?

Saturday, March 2nd, 2019

Rather than finding a way to provide for the small minority who still need health insurance, they want to overhaul the whole health system for everyone……………….

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Texas Addresses Balance Billing Issue

Friday, March 1st, 2019

A Texas Senate Bill was introduced a few days ago that addresses balance billing issues including credit reporting agencies……………….

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