“They’re Not Complying, and Nobody’s Accountable” Aequum LLC CEO, Christine Cooper, Weighs In On Federal Transparency Requirements

Currently, there is a lack of medical billing price transparency throughout the U.S. healthcare industry. According to an article now published in USA Today, a study finds few hospitals are meeting new federal transparency requirements, yet only two have faced fines. Starting January 1, 2021, price transparency rules require health systems to publicly post the … Continued

NSA Impact: What does the AHIP/Blue Cross Study Portend for Plan Sponsors?

In May, AHIP and the Blue Cross Blue Shield Association (BCBSA) announced the results of a study and analysis regarding the impact of the No Surprises Act (NSA). The survey defined a surprise medical bill as: Treatments by non-network providers that fell under the expanded definition of emergency services (including post-stabilization care) Non-emergency services by … Continued

Be Proactive Now…as Passive Enrollment is so Passé

Employers with a calendar year benefit plan year should begin preparing for annual enrollment starting now.   We are experiencing a period of rapid cost inflation and expect renewed, higher levels of health care cost inflation to soon follow. This comes as a large segment of Americans are already financially fragile – unprepared for regular … Continued

Pest Management: Minimizing Health Benefit Plan Losses Through Fee Disclosure

In the fifth and final webinar session of Humaculture, Inc.’s Hidden Opportunities, Strategic Compliance series, Jack Towarnicky, a member of aequum, confirmed how plan sponsors can lower costs and manage risk exposure through a more strategic approach to the new annual fee disclosure requirements. A focus on compliance might simply accept whatever disclosures are received. While … Continued

Mental Health Parity – A Lucid Approach

In the fourth of five webinar sessions, Mental Health Parity – A Lucid Approach, Jack Towarnicky, a member of aequum, joined industry professionals from Humaculture to identify the new mental health compliance requirements and to discuss why mental health issues, costs and administration continue to increase despite the 25+ year old promise of Mental Health … Continued

Mental Health Awareness Month: National Suicide Hotline – Dial 988

May is Mental Health Awareness Month. The National Alliance on Mental Illness (NAMI) reports that in 2020 one in five U.S. adults experienced a mental illness, one in fifteen experienced both a substance use disorder and mental illness, and one in twenty experienced a serious mental illness. The COVID pandemic has increased mental health issues … Continued

No Surprise – “Pure” RBP is Always Superior

Part 2 of Adopting a “Pure” Reference-Based Pricing Strategy The No Surprises Act (NSA) covers all participants in employer-sponsored health plans. It’s goal is to protect participants from surprise medical bills for charges in excess of negotiated rates with network providers. The NSA applies to emergency services as well as care received from out-of-network providers at … Continued

Litigation Update: No Surprises Act

aequum is mindful that government agencies adopt regulations that may extend the reach of or may conflict with the original text of the legislation. This update provides an overview and recent legal challenges to a portion of the law. According to research by the Kaiser Family Foundation and others, about 1 in 5 emergency department … Continued

Consumer Involvement in Reducing Medical Costs

Consumers do not have control over their medical costs or the billing process and they don’t like it.  According to a study conducted by Cedar (a financial technology platform): 31% of consumers are not satisfied with the coordination between their healthcare provider and payer; 40% are not satisfied with provider billing; 93% of consumers say … Continued