How to Make Reference-Based Pricing Work For Your Plan

aequum Provides Administrators with Partnership and Guidance aequum is a first-of-its kind tech-driven company in the complex field of medical billing. Our tech-driven team of specialists partner with claims administrators, providing them with data-driven insights, technical solutions and legal advocacy support. Working collaboratively, we are advancing the adoption of reference-based pricing (RBP) and price transparency … Continued

“Advanced” EOB Puts Economic Purchasing Power and Decision-Making Into Health Plan Member Hands

Christine Cooper, CEO of aequum LLC, provided eHealth Radio Network’s listening audience with guidance on strategies to take advantage of Advanced EOB price transparencies and advice that health care consumers can capitalize on to manage costs and fully optimize plan value. This insight has the potential to transform an employee’s health coverage usage, putting the … Continued

Bet on the “Over” not the “Under” – Commonwealth Offers an Incomplete Picture of Under-and-Over Insurance

A new survey by the Commonwealth Fund found that the number of Americans without health coverage has fallen to historic lows[i]. The same survey concluded that “a large number of people remain uninsured or inadequately covered.” Of the 6,301 survey respondents who were under age 65: 9% are not enrolled in health coverage[ii] 11% had a gap … Continued

aequum Collaborates with SIIA to Present Webinar on Reference Based Pricing

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

Litigation Update: AHA, AMA Dismiss Surprise Billing Rule Lawsuit, Plan Further Legal Action

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

Certainly Not What We Pay For

“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

aequum Member Jack Towarnicky Discusses Inflationary Impact on Employer-Sponsored Health Coverage with eHealth Radio Network

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

Increasing Health Care Premiums and Renewals

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

Q2 Insurer Performance

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

Hospital Price Transparency Update: Colorado House Bill 22-1285

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