An Aging Workforce Can Mean Higher Surgery Costs

As people live and stay active longer, you can expect more older people than ever in the workplace over the next four decades, and this can equate to an exponential rise in healthcare costs for plan sponsors. As AARP CEO Jo Ann Jenkins pointed out, when Ethel Percy Andrus first founded the institution in 1958, “there weren’t all that many older people around.”1 But that reality has completely changed. Consider these facts: Less than two… Read More →

Value-Based Surgery Benefits Enable Employers to Help Cash-Strapped Workers Get Needed Surgeries

Here are the troubling facts: 60 percent of bankruptcies are due to medical bills. Despite having year-round insurance coverage, 10 million Americans ages 19-64 face medical bills they cannot pay.1 About 15 percent of people say that at least once in the past two years, they couldn’t get the healthcare they needed; 58 percent of those said it was because they couldn’t afford it. And 19 percent of poll respondents report that they didn’t fill… Read More →

Provider Quality Counts in Choosing a Surgery Benefits Program

By Mark Stadler, President & CEO With the high cost of healthcare to businesses and workers, employers must rein in runaway spending. But it’s just as critical to provide workers with the very best care money can buy. This is what value-based healthcare is all about: quality care for less. Unfortunately, unwarranted variations in care are rampant, and provider quality is uneven in government and employer-sponsored health plans. Overuse and unnecessary care account for anywhere from… Read More →

Value-Based Surgery Benefits Advance Consumerism and Employee Engagement

By Shane Stone, Senior VP of Sales According to a recent survey of chief human resource officers and senior benefit managers, employees are suboptimal health consumers and do little shopping for the best cost and quality of care delivery.1 HR execs largely agree on the pressing need to move toward more consumerism.2  To enable greater consumerism, workers must be better educated on how to seek transparency and quality data when making specific healthcare decisions. But… Read More →

Huzzah for HHS Nominee Azar!

We applaud HHS secretary nominee Alex Azar for certain comments earlier this month. In testimony before the Senate Finance Committee, Azar supported mandatory bundled payment models in Medicare. We wholeheartedly agree. Mandatory bundled payment models are the logical next step by CMS based on findings of its Center for Medicare & Medicaid Innovation. Released in November 2017, an evaluation of Medicare’s Bundled Payments for Care Improvement initiative found that for the highest volume clinical episodes,… Read More →

Employers Armed With Innovative Weaponry Take Aim at High-Cost, Low-Quality Healthcare

By Jesse Gomez, Executive VP of Sales & Marketing Last year we witnessed the Trump administration, Congress and the American people engage in a fractious debate about healthcare reform. In a national discussion marked more by heat than by light, some called for an end to employer-sponsored insurance (ESI), but ESI shows no signs of going away and continues to meet the healthcare needs of a multitude.  The majority of Americans receive coverage from employers… Read More →

In 2018, Businesses Face Biggest Cost Hike in Years. What to Do?

By Mark Stadler, President & CEO  In a letter in 1789, Benjamin Franklin wrote, “In this world, nothing can be said to be certain except death and taxes.” A brilliant man, Ben was sadly mistaken. Just as certain, and unrelenting, is the rise each year in healthcare costs for employers and employees. These costs will climb again in 2018. HR consultancy Mercer tells us large employers will see a 4.3 percent increase in health benefit… Read More →

Disintermediation and Constructive Disruption in U.S. Healthcare

By Jesse Gomez, Executive VP of Sales & Marketing Retail giants CVS, Walgreens and Kroger, among others, are pushing further into care delivery, putting ever more pressure on traditional providers to up their game on access … or to partner. Private equity dollars are moving to mobile technology, new primary care delivery models and telehealth. Employers are contracting directly with providers for solutions that do more to contain healthcare costs and improve care quality.   While… Read More →

“Dantotsu” Can Pave Way to Better, Lower-Cost Healthcare for Plan Sponsors

By Mark Stadler, President & CEO For plan sponsors, managing healthcare today is a little like choosing dessert at a really good frozen yogurt shop: Too many choices can lead to analysis paralysis, beguiling the most seasoned benefit professionals.   Clarity comes from cherry picking the best care delivery and payment vehicles. Cherry picking in the business world originates in Japan, where for decades corporate leaders have practiced dantotsu – or, “best of the best” –… Read More →

Value-Based Surgery Benefits Improve U.S. Healthcare

By Mark Stadler, President & CEO The German literary giant Goethe famously said, “Every day we should hear at least one little song, read one good poem, see one exquisite picture and, if possible, speak a few sensible words.” Few words in our national discussion about healthcare are more sensible than these: We can improve much by moving from today’s fee-for-service (FFS) approach to value-based healthcare.  Value-based healthcare defined  The United States spends almost 18… Read More →