Warren Buffett Says US Health Care Must Be Revamped

Mar 21, 2019

Warren Buffett is the latest major figure to criticize America’s broken health care system, which is increasingly resistant to much needed changes. Members of the Everlong Group Medical Captive aren’t waiting for the system to fix itself.

If you want to learn how Everlong can lower health care costs while offering employees the same level of benefits, let’s talk.

 

Warren Buffett says US health care must be revamped or it will be left to the government — which will probably make it worse

CNBC

Complacency will make fixing the nation’s health-care system a daunting task, according to Warren Buffett, whose Berkshire Hathaway recently joined with J.P. Morgan Chase and Amazon to develop a new model for their 1 million employees.

Buffett along with Amazon’s Jeff Bezos and J.P. Morgan’s Jamie Dimon recently formed the health-care joint venture Haven to figure out how to deliver better health care at a lower cost. One of the problems with the current system, Buffett said in an interview for Yahoo Finance, is that health-care providers and others entrenched in the current model don’t have any incentive to change things.

“We have a $3.4 trillion industry, which is as much as the federal government raises every year, that basically feels pretty good about the system,” Buffett said. “There’s enormous resistance to change while a similar acknowledgement that change will be needed. And of course if the private sector doesn’t supply that over a period of time, people will say ‘we give up, we’ve got to turn this over to the government,’ which will probably be even worse.”

Read More: https://www.cnbc.com/warren-buffett-says-theres-enormous-resistance-to-change-healthcare

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Primary Care: An Amazonian-sized Effort

Mar 21, 2019

Combine direct primary care with a self-funded plan in a captive through Everlong and you’ll get lower costs and healthier employees.

If you are looking for a better way to purchase group health insurance, let’s talk.

 

Primary Care: An Amazonian-sized Effort

Catalyst for Payment Reform

Amazon is far from alone in this recognizing the barrier to primary care faced by many employees, especially those employees who are struggling to pay for health care in the face of increasing deductibles. Other employers have already taken steps to address this challenge.

PepsiCo made headlines in December of last year when the Dallas News reported that the company will waive all premiums and even give it’s Dallas-Fort Worth employees a $100 gift card for seeing a primary care doctor with one of three specified physician groups. When describing the bold solution, PepsiCo Director of Benefits, Betsy Harrison, recognizes what this financial incentive can signify for the population she works to cover, noting “That’s a big deal, especially for our hourly employees.”

Read More: https://www.catalyze.org/primary-care-amazon-increasing-access/

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Employer Health Care Prices Rose Three Times Faster Than Inflation

Mar 21, 2019

Employer health care prices are rising. Learn how Everlong has started to lower health care costs for employers.

If you are looking for a better way to purchase group health insurance, let’s talk.

 

Commercial healthcare prices rose three times faster than inflation

Modern Healthcare

Commercial healthcare prices in metro areas are rising while usage is falling, according to a new analysis.

Prices increased 13% as utilization dropped 17% from 2012 to 2016, a new iteration of the Health Care Cost Institute’s analysis of more than 1.8 billion commercial claims revealed. Metro areas with higher prices tended to have lower use, and vice versa, HCCI researchers found.

The report reinforces significant price variation for common medical procedures that contributes to rising U.S. healthcare spending.

Read More: https://www.modernhealthcare.com/finance/commercial-healthcare-prices-rose-three-times-faster-inflation

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White Paper: Leaving Money on The Table

Mar 18, 2019

The question isn’t should employers self-fund their health plan—it’s why haven’t they already? Self-funding is by far the most important thing employers can do to get control over their health plan’s costs and provide better benefits to their employees.

With the Everlong Group Medical Captive, there are self-funding options for employers with as few as 50 employees on the plan. If an employer has more than 150 employees on the plan, it’s hard to think of a reason not to self-fund. Maybe if their medical loss ratio, less high claimants, is consistently greater than 90% (assuming they can get that data from their health insurance carrier).

The percent of large employers who self-fund their plan rose dramatically between 1999 and 2018, but for mid-sized employers it remained flat. It’s not that self-funding makes less financial sense for mid-sized employers, it’s that they don’t understand the long-term risk and reward aspects.

In a nutshell, with self-funding, an employer pays an administrative fee to have an insurer or TPA administer their health plan—deal with providers, claims, etc.—and a premium for stop-loss insurance to protect them against really large claims costs.

The big difference is the employers pay their own claims. This means they get to see every claim and know exactly where every dollar is going. And they no longer pay the hefty margin above claims costs that carriers bake into their fully insured premium. Over a multi-year period, the savings are significant.

 

The Biggest Myth in Health Insurance

 

Typically, employer health plans will have one year out of every five where claims are abnormally high. Many employers are under the impression that a fully insured plan is less risky because the carrier will absorb or pool these high claims and cushion the employer. This is one of the biggest myths in health insurance.

The carriers do not “absorb” these costs; they recoup them by raising premiums the next year—sometimes by 30% to 50%. The employer is cushioned from the high claims costs only in the year they are paid. They get hit with them the following year in the form of a premium increase. Compounding the problem for employers is the fact that when claims costs come down, fully insured premiums rarely do, and future rate increases are based on the new higher baseline premium.

With a self-funded health plan, the employer will pay a portion of the additional costs during a high claims year, and stop-loss insurance will cover the rest. When claims costs come down in following years, so will the employer’s costs. The stop-loss premium may increase, but nowhere near as dramatically as a fully insured premium would have. The employer retains the margins above claims costs rather than giving that money to the fully insured carrier.

 

Everlong: Added Stability and Cost Control

 

Self-funding in the Everlong Captive provides an extra level of protection against volatility and premium increases. Everlong’s innovative risk pooling solution dampens the volatility in claims costs during the high claims years and even enables Members to get a portion of the stop-loss premium returned in good years. In addition, as Members of the Captive, employers have group purchasing power when negotiating stop-loss renewals, which helps to lower premium increases.

Self-funding in the Captive also enables employers to take advantage of Everlong’s best-in-class solutions to lower claims costs themselves. These include leading population health analytics and predictive modeling to drive effective disease management programs, a cost-effective and completely transparent Pharmacy Benefits Manager, and an innovative specialty drug program to rein in spiraling drug costs.

The Everlong Captive makes it easy and effective for mid-sized employers to enjoy the same benefits of self-funding as large organizations. Employers have saved hundreds of thousands—sometimes millions—of dollars over the years by self-funding in the Everlong Captive. That’s money that can be reinvested in better health benefits for the employees

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Healthcare Service Corp Got $1.7 billion Tax Refund Without Paying Federal Tax

Mar 15, 2019

Another $4.1 billion reasons more employers are looking to self-fund their group health plan in the Everlong Medical Captive.

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Blue Cross Blue Shield operator did not pay federal taxes in 2018, got $1.7B refund

The Hill

Health Care Service Corp., which operates Blue Cross Blue Shield plans in a handful of states, did not pay any federal taxes in 2018 and received a $1.7 billion tax refund, according to its latest financial report.

The tax refund boosted the health insurance conglomerate’s net profit to $4.1 billion last year, compared to $1.3 billion in 2017, according to Axios, which first reported about Health Care Service’s tax refund.

Axios noted that Health Care Service was one of the biggest beneficiaries of the GOP tax cut and has experienced rising profits from its health plans in the Affordable Care Act marketplace.

Read More: https://thehill.com/policy/healthcare/blue-cross-blue-shield-insurer-didnt-pay-any-federal-taxes-in-2018

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