Month: May 2026
PBMs Made Simple
By Shea Dimauro
PBM 101 is an educational series designed for self‑insured employers who want to better understand how pharmacy benefits actually work.
Continue reading PBMs Made SimpleChanging Behavior Doesn’t Lower Health Care Costs Because We Love Grandma
Grandma smiles devilishly while preparing toxic dish
“Lets put in a Wellness Plan!” says Linda in HR. “Our employees will become healthier! Healthier employees need less medical care and less medical care means lower health care costs!”
Continue reading Changing Behavior Doesn’t Lower Health Care Costs Because We Love Grandma% of Something Is Not A Price In American Health Care Finance
By Brian Cotter, MPA HSF
120% of Medicare. 50% Discount off Charges. Misused & Misunderstood. Neither is a price. Avoid putting either term in a contract without further definition. They are formulas…that can be manipulated!
Continue reading % of Something Is Not A Price In American Health Care FinanceThere Are Alternatives To High Cost Traditional Health Insurance
Family premium $2,000 a month + $7,500 deductible = $31,500 total out-of-pocket during a 12 month period before “real” insurance benefits begin.
Continue reading There Are Alternatives To High Cost Traditional Health InsuranceTwo Hospitals Blocks Apart, Same % of Medicare = Very Different Payment
The figures above use Hospital-with-Supplementals, the layer most people mean by “% of Medicare.” Bellevue is a public safety-net hospital. Its DSH and uncompensated care.
Continue reading Two Hospitals Blocks Apart, Same % of Medicare = Very Different PaymentRisk Management – Winging It Isn’t A Business Strategy”
“You can’t fix what you don’t see. You don’t know what you don’t know. We see opportunities others miss. We do what others don’t. Winning together is our goal.” – RiskManager.us
Continue reading Risk Management – Winging It Isn’t A Business Strategy”Snake Killer Consultants vs Animal Rights Consultants
“I come from an environment where if you see a snake, you kill it. At GM, if you see a snake, the first thing you do is hire a snake consultant. Then you get a committee on snakes and discuss it for a couple of years.” – Ross Perot
Continue reading Snake Killer Consultants vs Animal Rights Consultants