Where we’re going

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

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

The Recessionary Impact on Employer-Sponsored Health Coverage: Will it be Different this Time? Who Pays? How Much? The COVID-19 pandemic exposed a much larger segment of Americans as being financially fragile – living paycheck to paycheck and unprepared for regular household expenses, let alone out-of-pocket medical expenses. Now, compounded by a potential national recession, and … Continued

It really shouldn’t be this hard. Back in the fall of 2019, the Trump administration announced rules intended to create a market where healthcare consumers could shop for medical goods and services with price transparency. The idea is that people, with an ever-rising economic stake in the cost of healthcare, will compare prices and slow … Continued

Today, employer-sponsored health plan administrators benefit from billing partnerships that offer software and data-driven solutions. Real-time price information regarding the true cost of care enables plan sponsors and members to make the most advantageous cost-benefit decisions regarding care options. The right medical billing partner will be an agent of change, embracing innovation and advocating for … Continued

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

In the bottom of the ninth inning of a baseball game, score tied, bases loaded, two outs, everything on the line, a pitcher may decide to unnerve the hitter at the plate with a “brush back” pitch – a high and tight fastball. Very dangerous. Here, DaVita had “brushed back” Marietta (and perhaps all other … Continued

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

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

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