Where we’re going
Federal Reserve Report: Economic Well-Being of Households in 2022
A Federal Reserve report released in May evaluated the results from the 2022 Survey of Household Economics and Decisionmaking (SHED). Generally, the report found a decline in peoples’ financial well-being over 2021 and the self-reported financial well-being was among the lowest observed since 2016. With respect to health care expenses, the report found that many … Continued
May is Mental Health Awareness Month
May is Mental Health Awareness Month. It has been observed since 1949. This year the National Alliance on Mental Illness is celebrating with the More Than Enough campaign: It’s an opportunity for all of us to come together and remember the inherent value we each hold – no matter our diagnosis, appearance, socioeconomic status, background … Continued
‘No Surprises Act’ Website Captures Industry and Litigation Updates, Advances Understanding and Compliance
More than a year ago, the U.S. healthcare system marked a turning point with the passage of federal legislation that went into law intending to protect Americans from unexpected provider charges, a once common practice known as “balance billing.” Taking effect January 1, 2022, the No Surprises Act (NSA) covers patients and participants in employer-sponsored health … Continued
Reprise: Surprise Does Not Equal Unexpected When It Comes to Medical Bills
Just as Americans were starting to express a sigh of relief following an assumed end to medical balance billing under the provisions of the No Surprises Act, many health plan participants are experiencing the difference between “surprise” and “unexpected.” According to a survey conducted by Morning Consult, many respondents claim to have received surprise medical bills since the No … Continued
Self-Insurance: The Impact of Health Reform
Health Reform accelerated the trend to self-insure health plans, large and small. The Department of Labor’s annual reports have not identified any negative impact on participant benefits or the public marketplace exchanges. Plan sponsors of self-insured plans should ensure that plan document provisions authorizing the use of discretion by the plan administrator are in sync … Continued
A Year in Retrospect: How the No Surprises Act Impacted Medical Billing
The Best Response to the NSA is Still a Strategic and Compliant Approach One year ago, the United States marked a turning point for health care cost transparency with a new law aimed at helping Americans avoid unnecessary, unexpected medical debt. The No Surprises Act (NSA) was signed into federal law after years of negotiation between health … Continued
Post-Pandemic Era Poses Challenges and Opportunities for Employer Sponsored, Self-Insured Health Plans
Providing employees with access to affordable, quality healthcare is one of the greatest economic challenges for employers today. Finding the right balance between a benefit package that is both adequate and affordable — yet financially sustainable — has never been easy. Now, these efforts are compounded by COVID-19 and its significant post-pandemic challenges. While Plan … Continued
Credit Reporting of Medical Debt: An Update
In March 2022, the Consumer Financial Protection Bureau (“CFPB”) issued a 54 page report regarding the impacts of medical debt on consumers. The CFPB research showed that $88 billion in medical debt was on consumer credit records as of June 2021 and most medical debt collection tradelines[1] are under $500. In response, Equifax, Experian, and … Continued
What Role Does Health Reform Play in Annual Deficits, the National Debt and Today’s Debt Ceiling Debate?
Since the passage of Health Reform 13 years ago, annual deficits have added $19T+ to the national debt. America is now $31T+ in debt, in addition to significant underfunding of entitlements like Social Security and Medicare. There is a fierce debate underway in the beltway about raising the debt ceiling. President Biden proposes a budget … Continued
Self-Insured Health Plans and Primary Care Physician Practices Find Mutual Advantages of Direct Contracting
A growing number of primary care physicians are negotiating direct working relationships with self-funded employer-sponsored health plans. Direct Contracting is a payment model that shifts risk to a primary care group of physicians to provide a defined set of medical services in exchange for a monthly capitation fee. The model supplants the traditional fee-for-service reimbursement … Continued