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

Going Beyond Simple Compliance Requires Strategic Action

Since the start of 2022, Jack Towarnicky, member of aequum health, has joined benefits industry colleagues in presenting on a variety of topics as part of Humaculture’s Hidden Opportunities, Strategic Compliance Series. This five-part monthly webinar series offers guidance to plan sponsors and third-party claims administrators on how to strategically respond to the No Surprises Act … Continued

Adopting a “Pure” Reference-Based Pricing Strategy

Reference-based pricing (RBP) provides employers and employees greater control over health care costs through price transparency. The new transparency laws are expected to increase the use of RBP strategies by plan sponsors to maximize their value in managing costs value. This approach has potential to transform employees utilization of health care services, putting the economic … Continued

Leveraging Acquisition Cost Based Pharmacy Pricing

Jack Towarnicky of aequum health joined Scott McKibbin in presenting Hidden Opportunities: A “Dope” Response to Pharmacy “Transparency.” This was a third webinar in Humaculture’s Strategic Compliance Series that addresses how to strategically leverage the No Surprises Act (NSA) and Transparency in Coverage to create a competitive advantage. A recording of this webinar can be viewed here. Health … Continued

“Preserving the Harvest” by Leveraging Health Savings Accounts

Jack Towarnicky of aequum health joined Humaculture’s Steve Cyboran, Wes Rogers and Kelley Long on Thursday, February 17, to present the second installment of the Hidden Opportunities, Strategic Compliance series. They clarified why “unexpected” bills do not always mean “surprise” bills and demonstrated how Health Savings Accounts (HSAs) can be a strategic response to the No Surprises Act … Continued

One-Third of Americans Say They Can’t Afford to Contribute to an HSA

Harvard Business Review’s article sponsored by Centivo, Does Your Health Plan Leave Your Workers Functionally Uninsured?, can be boiled down to this one statement: “Unfortunately, one-third of Americans say they can’t afford to contribute to an HSA.” This assertion is made referencing Centivo’s December 2021 Healthcare and Financial report. Centivo surveyed 805 adults 18-64 years of … Continued

Credit Reporting of Medical Debt

On March 1, 2022 the Consumer Financial Protection Bureau (“CFPB”) issued a 54 page report regarding the impacts of medical debt on consumers.[1] “Medical bills placed on credit reports can result in reduced access to credit, increased risk of bankruptcy, avoidance of medical care, and difficulty securing employment, even when the bill itself is inaccurate … Continued