Where we’re going
No Surprises Act (NSA) Outcomes: Who Will and Won’t Be Paying More for Health Coverage in 2023
As healthcare inflation continues into 2023, medical providers are increasing their fees to maintain revenues. This financially impacts most employers and plan participants who can expect to pay more for health coverage and provider services this new year. According to a recent survey and analysis conducted by AHIP, during the first three quarters of 2022, … Continued
Publication of Hospital Ownership Information: Another Layer of Transparency
In November, in accordance with the Biden administration’s executive order on competition, the Department of Health and Human Services (HHS) published the Hospital Owners Information dataset (the Dataset). The Dataset is aimed at making transparent the ownership structure of Medicare-certified hospitals. The Dataset contains the following information about the more than 7,000 hospitals: Organization name, … Continued
How The Inflation Reduction Act’s Drug Coverage and Marketplace Subsidy Provisions Are Putting Pressure on Employee-Sponsored Healthcare Plans
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
Prepare Now for Surging Medical Costs: HSA and 401k Strategies Achieve Superior, Synergistic Savings
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
Cleveland Clinic to Charge for Patient Messages
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
Insight and Key Takeaways from SIIA’s National Conference & Expo on No Surprises Act
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
Ding Dong the “Glitch” is Dead
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
The Latest Legal Challenge to the Affordable Care Act: Texas Federal Court Decision Threatens Preventive Care Coverage
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
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