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 →

Healthcare Cost Outlook for 2017

Healthcare benefit costs are expected to increase 6% for large employers in the United States in 2017 according to a recent annual survey conducted by National Business Group on Health [1]. Many of the 133 employers surveyed for this study plan to make changes to their benefits plans in order to hold the increase at 5%. While a cost increase of some kind in 2017 is inevitable for employers, implementing cost-control measures as well as… Read More →

Quality Care and Patient Outcomes in the United States

Costs associated with major planned procedures have not only skyrocketed but also varied greatly. Accordingly, traditional PPO costs have risen dramatically—for both plan sponsors and members. To offset these increases, it has often meant a trade-off in the quality of care. Needless to say, high-quality healthcare remains a priority for Americans. Kaiser Family Foundation analysts have reported that while the quality of care in the United States’ health system continues to improve, there are still… Read More →

Rising Surgical Costs and How to Contain Them

The cost of surgical procedures in the United States continues to soar and seemingly sporadically rise. Stanford Health Care reported that 48 million surgical inpatient procedures were performed in the United States in 2009 [6], and that number continues to steadily increase seven years later. When surgical care becomes necessary, many consumers are left wondering what the true cost for them will be and how they will pay. Various explanations can be offered in the… Read More →

The Rise of Unexpected Medical Costs and the Impact on American Families

It’s unfortunately not uncommon for Americans to incur unexpected medical expenses and receive subsequent unplanned medical bills. Especially in emergency situations, consumers often receive treatment without knowing the true out-of-pocket cost to them. Getting clarity on healthcare costs through requesting itemized billing is something the Wall Street Journal recommends [1]. But even then, consumers can be left confused and frustrated with hefty, unanticipated medical bills. In 2015, Consumer Reports found that 30% of privately-insured Americans… Read More →

Getting Clarity on Surgical Costs

Healthcare costs can be confusing with a traditional health plan. Pricing practices from healthcare providers fluctuates frequently. Hospitals often bill different insurance payers varying prices for the same services. In some cases, insured patients receive a higher bill to subsidize the gaps left by uninsured patients. Other times, a specific provider’s cost can simply vary drastically from other providers performing the same procedures and services [1]. For inpatient surgical procedures, it’s not uncommon for a… Read More →

Americans Concerned About Rising Healthcare Costs

According to a recent survey from TransUnion Healthcare, approximately 76% of consumers are concerned about health insurance costs increasing. More than half (57.9%) of the people surveyed said the rising costs associated with health insurance have already added strain on their finances [1]. The costs associated with healthcare in the United States continue to affect families and businesses alike. For years, medical expenses and the cost of health insurance have steadily increased [2]. However, some… Read More →

Selecting a Top-Quality Provider is More Important Than Ever

It’s wise to always choose a medical provider that will provide the best results. Enlisting a top-rated provider will save patients time and, perhaps surprisingly, money. With the cost of healthcare as high as it is, one might assume that this also means the quality of the healthcare is also high. However, this commonly isn’t the case. A large amount of medical expense is not necessarily proportionate to the quality of care that will be… Read More →