The Hidden Cost of Paying a Claim
When we talk about healthcare cost containment in employee benefits, the conversation almost always lands on network discounts, drug rebates, prior...
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When we talk about healthcare cost containment in employee benefits, the conversation almost always lands on network discounts, drug rebates, prior...
Reference-based pricing (RBP) fundamentally alters how employers pay for healthcare by shifting from a traditional percentage-of-billed-charges model to a...
Mental health parity laws, primarily the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 and the Affordable Care Act (ACA), require that...
You dodged the penalty. Kept your headcount under 50. Filed the right codes on your 1094-C. The IRS isn't coming after you. Feels like a win, right? But...
You’ve heard the pitch: reference-based pricing slashes healthcare costs by paying a fair multiple of Medicare, bypassing bloated networks, and saving 20 to...
Every renewal season, you do the same dance. You pull claims reports. You benchmark against similar groups. You brace for the trend curve. And you haggle....
The short answer is: potentially significantly, but with important caveats. Employee wellness incentive programs, when designed and implemented...
Every fall, it's the same scene. You sit in a conference room, someone clicks to a slide that says "Projected Medical Trend: 7.5% to 9.0%," and everyone...
Artificial Intelligence is rapidly transforming employer-sponsored healthcare from a reactive, cost-intensive system into a proactive, value-driven one. Its...
If you run a self-funded health plan, you know the drill every year. You send your stop loss carrier a stack of claims from the past 12 to 18 months. They...
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