President Trump’s executive order on price disclosure should be a huge win for transparency in health care. The Everlong Group Medical Captive already helps employers and their employees get greater transparency into their health care costs.

Contact us to learn more.

Trump Order Would Inform Consumers About Health-Care Prices

Wall Street Journal

President Trump will issue an executive order to compel price disclosure in health care, an initiative that could upend industry practices and give consumers more information on their out-of-pocket costs.

The order, to be signed on Monday, will direct federal agencies to pursue administrative actions that would require hospitals to publicize their negotiated rates with insurers. Hospitals and insurers typically closely guard the discounted rates in payment contracts and they are generally bound by confidentiality agreements.

Read More: https://www.wsj.com/articles/trump-order-would-give-consumers-more-information-on-health-care-prices-11561384725?mod=hp_lista_pos2

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

There are many factors to consider if you are exploring a move to RBP. This checklist from Maestro Health’s Scott Bennett provides 38 potential questions to ask before moving forward.

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

A Checklist of Considerations For A Reference-Based Pricing Product:

Maestro Health

While this checklist is not comprehensive, it is a good start for an informed discussion among interested parties about the move to Reference-Based Pricing (RBP) and many of the key considerations. A review of the answers would probably indicate who is “on fire”: the deal or the dealer.

Experience:
How long has the vendor been offering RBP products?

Process:
How does the RBP program integrate into the TPA claim process, is it independent or coordinated?

Documentation:
Does the applicable plan document accurately reflect (within its provisions) the pricing methodology being utilized?

Read More: https://www.linkedin.com/pulse/checklist-considerations-reference-based-pricing-product-bennett/

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Self-funding in the Everlong Group Medical Captive helps employers manage volatility in their claims costs. Our team will work with broker-consultants to find innovative stop-loss insurance plans for your clients.

For more information on our innovative cost-saving solutions, contact us today.

Time for Self-Funded Health Plan Sponsors to Revisit Stop-Loss Insurance

PLANSPONSOR

There has been a lot of interest in plan sponsors using self-insured health plans since the passage of the Affordable Care Act (ACA).

For employers seeking stop-loss deductibles of $1 million or more, utilizing a captive can help by accessing reinsurance markets.

“For larger employers who have traditionally not purchased stop-loss insurance in the past, they need to reevaluate their risk because of the changing nature of large claims,” says Fuerstenberg.

Read More: https://www.plansponsor.com/exclusives/time-self-funded-health-plan-sponsors-revisit-stop-loss-insurance/

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As prescription drug prices skyrocket, employers can’t afford to wait around for the broken group health insurance system to fix itself. Everlong provides multiple options to help lower high claims and rising prescription drug costs.

To hear about how employers have saved millions of dollars by self-funding in the Everlong Group Medical Captive, contact us today.

We’re in the middle of a specialty medication storm. Now what?

Employee Benefit Adviser

What began subtly 15 years ago — with $15,000 drug treatments seen as “extremely high”— picked up a few years ago with certain treatments for rheumatoid arthritis and Hepatitis C, for example, surpassing $50,000. Today we’re in a full-blown hurricane. For example, on my desk today is a specialty medication claim for $750,000.

What can midsize employers sponsoring self-funded health plans do to weather this storm? Step one is covering prescription drugs under stop-loss insurance.

Now’s a great time, in concert with your benefits consultant, TPA and PBM, to review your contracts, plan documents and clinical programs and ask for recommendations.

Read More: https://www.employeebenefitadviser.com/opinion/cover-prescription-drugs-under-stop-loss-insurance

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At Everlong, we offer an innovative group medical captive that will help with Secretary Azar’s assessment that employers need to help fix the broken health insurance system.

Click here to learn how self-funding in the Everlong Group Medical Captive can help your company’s bottom line.

HHS Secretary Azar Wants Employers to Help Control Health Care Costs

SHRM

To help rein in health care costs, employers can avoid plans with “backdoor rebates” on prescription drugs; contract directly with hospitals; and guide employees to high-quality, competitively priced doctors, Health and Human Services (HHS) Secretary Alex Azar said last week.

While people often look to the government to drive changes in U.S. health care, employers “represent a hugely important force, in many ways as important or more important than the federal government” because of the 180 million people in the U.S. who receive job-based health coverage, Azar said April 11 at the National Business Group on Health’s (NBGH’s) Business Health Agenda 2019 in Washington, D.C.

“No American should be going bankrupt due to the cost of health care services,” Azar told the group representing large U.S. employers. The cost of health services and prescription drugs “should be accessible, transparent and, to the extent possible, predictable,” he said. “We need new levels of competition in health care so that market forces can increase quality and drive down costs, just like they do throughout the rest of our economy. We need transparency around price and quality so that individual consumers and, in some cases, third-party payers can drive that transformation.”

Read More: https://www.shrm.org/resourcesandtools/hr-topics/benefits/pages/azar-asks-employers-to-help-control-health-care-costs.aspx

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