Where we’re going

Long ago, the designers of health reform predicted that, by 2025, only a minority of the employers who offered coverage in 2010 would still be providing coverage in 2025. It now seems like each iteration of the Affordable Care Act, as well as subsequent legislation, is nudging businesses toward that outcome. Specifically, the Inflation Reduction Act … Continued

It’s never too early for plan sponsors to incorporate the most effective strategies for addressing today’s healthcare inflation and economic challenges. To alleviate “financial fragility” when it comes to the medical expenses that their participants are not prepared to pay, a Health Savings Account (HSA) strategy is capable of “Quadruple Duty” – covering Medicare premiums, … Continued

The Cleveland Clinic announced that on November 17, 2022 it would begin billing patients’ insurance for messages that require five minutes or more of a healthcare provider’s time to answer.  The announcement provides: [S]tarting November 17, 2022, MyChart responses that require your provider’s clinical time and expertise to answer may be billed to your insurance. … Continued

The buzz around this year’s Self-Insurance Institute of America (SIIA) National Conference & Expo was the status and outlook of the No Surprises Act (NSA) and the comprehensive legislation challenges to addressing surprise medical billing at the federal level. Most sections of the legislation went into effect Jan. 1, 2022, and the Departments of Health … Continued

New regulations will increase the annual deficit and national debt ultimately shouldered by taxpayers – today and tomorrow. The Biden Administration recently finalized regulations to extend taxpayer subsidized medical coverage to millions of Americans who may not have previously qualified for the subsidy. They accomplished this by updating the 2013 definition of “affordability” with respect … Continued

Key Points: A court decision by a judge in Texas may increase out-of-pocket costs for preventive health care services. This case reintroduces a  dispute that the ACA resolved with a mandate of coverage. While health mandates to provide certain services without cost raised the cost of coverage, re-introducing cost sharing for these preventive services could … Continued

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

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

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

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