Knowing the costs of medical procedures and services upfront will enable the consumer to make informed choices and encourage more competition amongst the healthcare supply chain. To learn about yet another way Everlong can help brokers fix a broken system for their clients, visit our website and contact us.

Trump Administration Preparing Executive Order on Health-Cost Disclosure

Wall Street Journal

Directive for price transparency could be released next week amid growing pushback against industry’s secrecy.

President Trump is expected to release an executive order as early as next week to mandate the disclosure of prices in the health-care industry, according to people familiar with the discussion.

The order could direct federal agencies to pursue actions to force a host of players in the industry to divulge cost data, the people said.

Read More: https://www.wsj.com/articles/trump-administration-preparing-executive-order-on-health-cost-disclosure-11558690320?mod=hp_lead_pos7

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Yes, the costs of specialty drugs are a big problem, but the innovative Everlong group medical captive has a solution. To learn about yet another way Everlong can help brokers fix a broken system for their clients, visit our website and contact us.

Has Stop-Loss Insurance Lost Its Value?

CFO Magazine

Claims of $10 million, $20 million, or bigger are hitting employers like bolts of lightning, blowing up self-insured health budgets. Most often, these claims are driven by specialty drug treatments for rare, extreme conditions like hereditary angioedema and hemophilia.

Because the drug treatment protocols for conditions like hereditary angioedema and hemophilia are more maintenance-like than curative, those $10 million to $20 million claims are becoming annuities.

The traditional approach to mitigating the risk of catastrophic claims is to buy stop-loss insurance. But buying stop-loss — through direct markets or by accessing reinsurance markets through a captive insurance operation — may not be a complete solution.

Read More: http://www.cfo.com/health-benefits/2019/05/is-stop-loss-insurance-losing-some-of-its-value/

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Reference-based pricing is not for everyone. But, when done properly, it can decrease healthcare costs while providing greater price transparency for employees.

Contact us to learn how some employers in the Everlong Medical Captive are already benefiting from reference-based pricing solutions.

Reference-Based Pricing Provides Transparency

Employee Benefit Adviser

A big problem in the healthcare industry is that most employees aren’t aware of the prices of certain medical services until they receive the bill.

“There’s no cost transparency in our current healthcare system,” said Marty Joseph, president of HealthComp Holdings, a Fresno, California-based healthcare administration company. “Reference-based pricing is the solution”

The method typically does not involve a traditional insurance carrier or provider network negotiating covered services for the plan. Instead, employers set a fixed limit on the amount a plan will pay for certain health services. This can help plan sponsors cut costs by capping what the plan covers for some medical procedures where fees can vary widely.

Read More: https://www.employeebenefitadviser.com/news/should-employers-proceed-with-reference-based-pricing

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Everlong is keeping up with the rise of data science by utilizing Springbuk’s sophisticated data analytics to modernize health initiatives.

Contact us to learn more about how Springbuk’s Health Intelligence software can reduce your group healthcare costs.

Deep Learning Is Modernizing Health Initiatives

Employee Benefit Adviser

Deep learning is a subset of AI and machine learning, which is a broader category in the field of computer science. It offers benefit advisers promising new ways to help their employer clients improve healthcare services and consumer experiences.

Experts see tremendous potential in terms of streamlining both the delivery and operational efficiency of employer-provided healthcare benefits to improve outcomes and reduce costs.

Deep learning capabilities include analyzing medical imaging and diagnoses, as well as decreasing both the cycle time and cost in drug discovery.

Read More: https://www.employeebenefitadviser.com/news/deep-learning-ai-improving-healthcare-benefit-strategies

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If you don’t know the costs, how can you control them? 

The push for transparency on medical prices between insureds and hospitals is vital. Everlong believes fully in both transparency and controlling costs. If that describes what you are looking for, let’s talk.

Traditional Health Insurance Lacks Price Transparency

New York Times

In Indiana, a local hospital system, Parkview Health, charged private insurance companies about four times what the federal Medicare program paid for the same care, according to a study of hospital prices in 25 states released on Thursday by the nonprofit RAND Corp.

Colorado employers were shocked to learn they were paying nearly eight times what the federal government did for outpatient services like an emergency room visit, an X-ray or a checkup with a specialist.

The disparity shows how competition has faltered in an opaque market where the costs of care are secret and hospital systems are increasingly consolidated, gaining outsize clout in price negotiations with employers.

Many businesses that contract with insurance companies have no idea what their insurers are paying individual hospitals in their plan’s network. “We’ve never seen what was agreed upon,” said Jennifer Fairman, the benefits manager for people who work for Larimer County in Colorado.

Read More: https://www.nytimes.com/2019/05/09/health/hospitals-prices-medicare.html?

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