Where we’re going

Christine Cooper and Jack Towarnicky presented on behalf of aequum Reference Based Pricing – Optimized, A Strategic Response to the No Surprises Act, Transparency Requirements. This complimentary webinar, in collaboration with the Self-Insurance Institute of America (SIIA), confirmed why reference-based pricing (RBP), “done right”, is the most appropriate plan design response to recent legislation – … Continued

Summary: The American Hospital Association (AHA) and American Medical Association (AMA) filed a motion to dismiss their lawsuit challenging the federal government’s final rule on surprise billing released last year, but cautioned more litigation is pending. The health care lobbying groups say the August 2022 final rule on arbitration still poses concerns for providers.   … Continued

“Americans born in 2021 can expect to live for just 76.1 years — the lowest life expectancy[1] has been since 1996, according to a new government analysis published Wednesday [August 31]. This is the biggest two-year decline — 2.7 years in total — in almost 100 years.”[2] In the August 2022 Vital Statistics Rapid Release, … Continued

With annual enrollment approaching, employers and employees alike are at heightened levels of concern over the potential for significant increases in premiums and their potential to trigger increases in employer and employee contributions as well as point of purchase cost-sharing (deductibles, copayments, coinsurance, etc.). A near confirmed national recession, coupled by an ever-increasing rate of inflation, … Continued

With health insurance annual enrollment period approaching, employers and employees alike are at heightened levels of concern over the potential for significant increases in renewal premiums and point of purchase cost-sharing. The combined impact of a slowdown in the U. S. economy coupled with an ever-increasing rate of inflation, has Americans anxious over “what’s next” in … Continued

Most, but not all, healthcare insurers saw rising profits in Q2. Leading the pack was Molina with a 34% increase over 2021 Q2 results. UnitedHealth Group’s profits rose 19% for the same period. In United Health’s July 15, 2022 earnings announcement the Company said, “Growth in the second quarter was balanced across the company’s businesses, … Continued

A new Colorado legislative enactment prohibits hospitals that are not in “material” compliance with the price transparency laws[1] from pursuing a “collection action” from a patient or guarantor. Compliance is determined as of the date the services or items[2] are provided to the patient. Collection actions include (i) referral to a collection agency, (ii) commencement … Continued

The Recessionary Impact on Employer-Sponsored Health Coverage: Will it be Different this Time? Who Pays? How Much? The COVID-19 pandemic exposed a much larger segment of Americans as being financially fragile – living paycheck to paycheck and unprepared for regular household expenses, let alone out-of-pocket medical expenses. Now, compounded by a potential national recession, and … Continued

It really shouldn’t be this hard. Back in the fall of 2019, the Trump administration announced rules intended to create a market where healthcare consumers could shop for medical goods and services with price transparency. The idea is that people, with an ever-rising economic stake in the cost of healthcare, will compare prices and slow … Continued

Today, employer-sponsored health plan administrators benefit from billing partnerships that offer software and data-driven solutions. Real-time price information regarding the true cost of care enables plan sponsors and members to make the most advantageous cost-benefit decisions regarding care options. The right medical billing partner will be an agent of change, embracing innovation and advocating for … Continued