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Risk Managers Blog 10/14/2019 14:15
Sleepy TRS trustees are considering “big changes” to TRS ActiveCare because member districts are threatening to leave to establish their own health plans. Competition, for the first time, is clearly at play here. The TRS solution? Eliminate community rating and utilize narrow networks…………….. SOURCE: TSTA.ORG The Teacher Retirement System (TRS) is considering a new approach […]
Risk Managers Blog 10/13/2019 10:49
Specialty drugs can cost hundreds of thousands of dollars per member per year, or more. One new specialty drug approved this year costs +$2,000,000 for an annual treatment……… By Bill Rusteberg Specialty drugs are a ticking time bomb that can bankrupt a self-funded health & welfare plan. Stop loss insurance may mitigate the risk during […]
Risk Managers Blog 10/11/2019 16:17
We have reached a tipping point in the battle against high cost health care. Employers have run out of money to pay for it. Employees can’t afford to use their health insurance anymore. Meanwhile hospitals continue to game the system with egregious charge master pricing and the disco-discount game with their carrier partners. They have […]
Risk Managers Blog 10/09/2019 10:44
Proposal will take Colorado down several relatively untraveled roads, potentially creating a health insurance market like no other in the country that could become a national model — or a cautionary tale…………….. Dan Meylan sent us the following email this morning along with an article describing Colorado’s proposal to adopt Reference Based Pricing strategies in that […]
Risk Managers Blog 10/06/2019 10:11
A team of Jerusalem-based researchers and entrepreneurs claim they have a cure for diabetes that could hit the market as early as within the next few years…………..The patient should never have to inject insulin into his body again……………… ISRAELI SCIENTISTS: CURE FOR INSULIN-DEPENDENT DIABETICS WITHIN FIVE YEARS “This is a new way to treat diabetes,” said CEO […]
Risk Managers Blog 10/06/2019 09:58
AMPS saw significant growth in its large customer portfolio this year, including customers with upwards of 150,000 members. The growth from small to midsize to large customers reflects broad embrace by employers and health systems…………….. MyHealthGuide Source: Advanced Medical Pricing Solutions (AMPS) via P&T Community, 10/1/2019 ATLANTA — Advanced Medical Pricing Solutions (AMPS) announced that […]
Risk Managers Blog 10/03/2019 16:49
An idea with bi-partisan support? By Bill Rusteberg If the federal government would rent their Medicare network and charge what the private market charges for PPO access, the government would rake in millions, if not billions of dollars in access fees. This would generate enough money to buy health insurance for those that don’t need […]
Risk Managers Blog 10/02/2019 13:37
According to one source, Hartford Life Insurance estimated that one-quarter of all Fortune 500 companies have COLI policies, which cover the lives of about 5 million employees. Can proceeds go to reduce GASB 45 ? Corporate-owned life insurance From Wikipedia, the free encyclopedia Corporate-owned life insurance (COLI), is life insurance on employees’ lives that is owned by the employer, with […]
Risk Managers Blog 09/30/2019 15:52
Indiana Jones (Michael Hicks) Blows Whistle “What I discovered will deeply anger every Hoosier and should embarrass most hospital administrators and board members. I also expect it to cause significant changes to state policy with respect to these hospitals. This is likely to change the way we tax them, regulate their competitors and enforce anti-trust […]
Risk Managers Blog 09/30/2019 13:58
“There is a sense among employers that it is time to think creatively and broadly about changing the system. In 2020, medical cost trend will continue its march upward, but not without employers working to slow and perhaps even stop that march.” This PWC (see link below) report is a good read. Two paragraphs worth […]
Risk Managers Blog 09/30/2019 13:48
Hospitals say price transparency won’t lower prices. So what will? Hospitals and insurers question legality, need for CMS price transparency rule by Robert King | Sep 27, 2019 Hospitals and insurers want the Centers for Medicare & Medicaid Services to get rid of a proposal for facilities to post payer-negotiated rates in a searchable, online format. Hospitals […]

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