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Category: Cost

Narrow Networks Can Result in "Surprise" Bills for Patients and Employers

We've all heard the stories, or even experienced it ourselves, about finding out after-the-fact that the anesthesiologist used during surgery was out-of-network and, therefore, the patient and employer owe a lot more for those services that expected. This happens even though the hospital is in-network. This situation is becoming even more frequent due to the expanded number of narrow-networks put in place with the advent of the Marketplace (aka public health insurance exchange) and in the... Read More
Posted by Cristie Travis at Monday, August 31, 2015 | 0 comments

New, Very Expensive Treatments for Cholesterol Approved

NOTE: MBGH's new, specialty pharmacy management program for members is exactly what employers need to make the tough decisions around how to manage the costs of the new, very expensive treatments for high cholesterol, while still getting this treatment to those that need it. Contact Cristie at ctravis@memphisbusinessgroup.org to learn more. Two drugs in a new class of cholesterol-lowering treatments have now been approved by the FDA --  Praluent, made by Sanofi Regeneron... Read More
Posted by Cristie Travis at Monday, August 31, 2015 | 0 comments

Health Care Cost Increases Picking Up Speed

Drew Altman, in his June 11, 2015 WSJ blog post, believes the "lowest of the lows of the health cost slowdown are now in the rear view mirror" and as the economy has recovered, people are using more health care services. In addition, more people covered through health reform are likely impacting the increase as well. Read the blog post here . Read More
Posted by Cristie Travis at Friday, June 19, 2015 | 0 comments

How One Employer Saved $3.5million in Health Benefit Costs

The results of a dependent audit saved Baptist Health, an 18-facility health care system based in KY, $3.5 million according to an article in HealthLeadersMedia.com. Check out how they conducted their audit and see if you have incorporated the same best practices! Define "dependent" and then stick to it Give fair warning (and get some voluntary terminations!) Consider "amnesty" for past offenses Read More
Posted by Cristie Travis at Tuesday, October 28, 2014 | 0 comments

Beginning to See the Change We Want

An insightful article by Mark Hepler, CFO of Munson Healthcare, an 8-hospital system based in Traverse City, MI, on HealthLeadersMedia.com, reveals that health care providers, well, at least his, are beginning to make the changes that we want to see and that have, to a large extent, been spurred by the Affordable Health Care Act (see recent blog post on whether the ACA is working). What changes are happening in how health care is delivered? Investing in becoming clinically... Read More
Posted by Cristie Travis at Tuesday, October 28, 2014 | 0 comments

Specialty Drugs to Account for 50% of Pharmacy Spend by 2018

Wonder why specialty drugs are likely to account for 50% of pharmacy spend by 2018? Here are three reasons: Supply and demand. Only 3.6% of the commercial population use specialty drugs so the market for these drugs is very small. On the other hand, the development costs are very high, resulting in high costs per patient. No generics . Specialty drugs are often too complex to be produced under generic requirements. LImitations on price increases once on the market. Manufacturers... Read More
Posted by Cristie Travis at Monday, October 27, 2014 | 0 comments

September 29 Webinar: Access to Specialty Medications & Value-based Insurance Design

Join the National Pharmaceutical Council for a webinar on September 29 from 12:00-1:00 CT.  NBCH's CEO, Brian Klepper, will present on the webinar along with a panel of other leading health and benefits experts. Read the webinar announcement from NPC below and register online today .  Specialty medications have been making health care headlines in recent months because of their effectiveness and higher costs. How can we ensure that patients will have access to the treatments that... Read More
Posted by Cristie Travis at Wednesday, September 17, 2014 | 0 comments

Employer-Sponsored Family Health Premiums Rise 3% in 2014

From the National Business Coalition on Health: Average annual premiums for employer-sponsored family health coverage reached $16,834 this year, up 3 percent from last year, continuing a recent trend of modest increases, according to the Kaiser Family Foundation (KFF)/Health Research & Educational Trust (HRET) 2014 Employer Health Benefits Survey released September 10, 2014.  Workers on average pay $4,823 annually toward the cost of family coverage this year.  Get all the... Read More
Posted by Cristie Travis at Wednesday, September 17, 2014 | 0 comments

Data Brief on Trends in Employer-Sponsored Insurance

From the National Business Coalition on Health: Recent accounts of employers dropping health coverage, restricting eligibility for spouses, turning to plans with narrower networks and greater cost sharing, and restructuring workforces are often framed as side effects of the ACA.  But many of these cost-cutting trends began long before health reform. This data brief  and data charts from the National Institute of Health Care Management offers a comprehensive look at how... Read More
Posted by Cristie Travis at Monday, October 21, 2013 | 0 comments

Engaged Employees Exercise More, Eat Healthier

The Gallup Daily tracking interviews in 2012 showed that engaged employees eat healthier and exercise more than non-engaged employees or disengaged employees.  This is not the first connection Gallup research shows between employee engagement and health. Previous Gallup research shows that engaged employees: Are healthier overall with fewer chronic diseases and lower obesity rates Are 21% more likely to participate in worksite wellness programs Gallup points out that it is not... Read More
Posted by Cristie Travis at Wednesday, March 13, 2013 | 0 comments

More Physician Groups Release Lists of Tests and Procedures We May Not Need

On February 21, 2013,  the Choosing Wisely® campaign released an additional 18 lists of tests or procedures to question, highlighting potentially unnecessary — sometimes harmful — care provided in the United States.   More than 130 tests and procedures to question have been released as part of the ABIM Foundation’s Choosing Wisely® campaign, which aims to spark conversations between patients and physicians about what care is really necessary.   Each specialty society... Read More
Posted by Cristie Travis at Monday, March 11, 2013 | 0 comments

Giving Cost Info to Providers May Not Change Ordering Habits

From the National Business Coalition on Health: In a new article published in the Journal of the American College of Radiology, researchers found that giving providers the cost information at the point of order entry made NO difference in which tests were ordered. Therefore, provider cost transparency alone does not significantly influence inpatient imaging utilization. While this research was conducted entirely within one specialty, there may be significant implications for... Read More
Posted by Cristie Travis at Tuesday, February 12, 2013 | 0 comments

Consumer Attitudes on Health Care Costs

From the National Business Coalition on Health : New Robert Wood Johnson Foundation research shows many Americans don't understand why health care costs are increasing nor how the trend affects them on a daily basis. RWJF orchestrated a series of eight focus groups in four major U.S. cities: Chicago, Denver, Philadelphia and Charlotte, N.C. Four of the focus groups included people with employer-sponsored health insurance, two groups were comprised of people who were self-insured, one group was... Read More
Posted by Cristie Travis at Saturday, January 12, 2013 | 0 comments

Employer Health Insurance Premiums Rose 62%, Deductibles More Than Doubled 2003-2011

From the National Business Coalition on Health: Average premiums for employer-sponsored family health insurance plans rose 62 percent between 2003 and 2011, rising far faster than incomes did in all states, according to a new Commonwealth Fund analysis that tracks trends in job-based coverage state by state. The study also finds that annual costs for the share of insurance premiums paid by workers grew an average of 74 percent, and deductibles more than doubled during the period. Total... Read More
Posted by Cristie Travis at Thursday, December 27, 2012 | 0 comments

State of Tennessee Wins Excellence in Value-Based Purchasing Award

The State of Tennessee, a member of Memphis Business Group on Health (MBGH), was presented with the Employer Excellence in Value-Based Purchasing Award at the National Business Coalition on Health’s (NBCH) annual conference. The award is sponsored by Ethicon Endo-Surgery and Johnson & Johnson Health Care Systems. At the awards ceremony, Cristie Upshaw Travis, MBGH CEO, thanked the State on behalf of the citizens and tax payers of Tennessee, for taking bold steps to reign in the costs of... Read More
Posted by Cristie Travis at Thursday, November 15, 2012 | 0 comments

ACA Will Raise Costs for Mid-Sized Employers

From the National Business Coalition on Health:  President Obama's healthcare law won't erode employer-based health insurance — but it will raise some companies' costs by nearly 10 percent, according to a new analysis from the Urban Institute. Although the law's critics usually focus on small businesses, the new paper says medium-sized firms will see the biggest cost increase. Mid-sized businesses — firms that have between 101 and 1,000 employees — would have... Read More
Posted by Cristie Travis at Wednesday, October 10, 2012 | 0 comments

Higher Prices Drive Cost Increases in Employer-Sponsored Insurance Plans

"Despite some increases in utilization,HCCI found spending growth was driven primary by increases in prices paid." That's the bottom line of a report just released by the Health Care Cost Institute (HCCI) which found that per capita healthcare spending for employer-sponsored health insurance plans rose by 4.6%, breaking the trend of decreasing "increases" seen over the past three years. (NOTE: this report focuses on spending as measured through claims, not on premiums) Major findings... Read More
Posted by Cristie Travis at Thursday, September 27, 2012 | 0 comments

Working to Get the CDC's Diabetes Prevention Program to Memphis!

As those of you that attended our September 6, 2012 Annual Conference know, MBGH is working through the National Business Coalition on Health and the CDC to get the CDC's National Diabetes Prevention Program to Memphis! This evidence-based, small-group setting, lifestyle coaching program is geared toward pre-diabetics, to help them not develop full-blown Type 2 diabetes. We know that generally, there are about 2.5 times as many pre-diabetics in the US as diabetics and the only way to slow... Read More
Posted by Cristie Travis at Friday, September 21, 2012 | 0 comments

Adult Obesity Rates Could Exceed 60% in TN by 2030

As you read this article on the impact of diabetes in the US and Tennessee and the potential we have to decrease the financial as well as disease-related impact by just decreasing our average BMI by 5%, consider participating in MBGH's efforts to bring the Center for Disease Control's National Diabetes Prevention Program to Memphis and Tennessee! See the presentations from our Annual Conference on this evidence-based, highly successful program and contact Cristie Travis at ... Read More
Posted by Cristie Travis at Thursday, September 20, 2012 | 0 comments

Poor Health Costs Employers $227 Billion in Lost Productivity

Take the MBGH Brief Worksite Health Assessment to see if you have the evidence-based policies, environmental and social supports in place to work in conjunction with your health benefit to increase the health and productivity of your employees! All participants in the survey will receive a report summarizing major findings so you can use it to benchmark your worksite programs with other employers across Memphis.Then read how poor health impacts your bottom line! From the National... Read More
Posted by Cristie Travis at Tuesday, September 18, 2012 | 0 comments

Survey Shows Increase in Consumerism

From the National Business Coalition on Health: Patients are morphing into health care consumers with growing use of technology for medical shopping and health engagement, according to a survey conducted by Altarum, the health services research organization. Virtually all (99%) of U.S. health citizens want to play a role in medical decisions about their care. However, consumers vary in just how much of that responsibility they want to assume: - 35% want to make the final decision with... Read More
Posted by Cristie Travis at Tuesday, September 18, 2012 | 0 comments

Providers Offering Price Guarantees to Insurers to Stabilize Employer Health Costs

From the National Business Coalition on Health: According to  Forbes , one of the Midwest’s largest providers of medical care is bringing a price guarantee to a new concept being pushed by the Obama administration that rewards doctors and hospitals for working together to improve quality and cost. Milwaukee-based Aurora HealthCare has formed an Accountable Care Organization (ACO) that is working with Aetna Inc. and Wellpoint subsidiary Anthem Blue Cross and Blue Shield in Wisconsin... Read More
Posted by Cristie Travis at Tuesday, August 28, 2012 | 0 comments

Employers Turn to Biometric Data To Manage Costs

From the National Business Coalition on Health: As employers continue to use wellness programs to improve employee behavior and their health, many are taking advantage of benefits automation tools; however, they also have not reached the potential for cost savings and operational efficiency, according to the 2012 Wellness & Benefits Administration Benchmarking Study by bswift. “Employers are actively modifying and upgrading their wellness programs as they learn from experience,... Read More
Posted by Cristie Travis at Thursday, August 23, 2012 | 0 comments

Top 10 Hospital Contracting Priorities

While there is a lot of focus in the press and push from employers for hospitals to develop new, more efficient, higher quality delivery models, hospitals are still focused on the basic "blocking and tackling" of running a hospital and that is shown clearly in the results of a recent survey of 400 hospital executives by Revive Health. The Top 10 contracting priorities are primarily about increasing revenue through negotiating higher rates, decreasing denials, increasing coverage,... Read More
Posted by Cristie Travis at Thursday, August 23, 2012 | 0 comments

Survey Finds Wellness Strategies Gaining Traction as Way to Curb Health Cost Increases

From the National Business Coalition on Health: Global costs for employee health benefits are expected to increase this year, but wellness programs are gaining traction as a way to keep people healthier and lower long-term costs, according to the  2012 Towers Watson Global Medical Trends Survey  of insurers. Towers Watson officials say the rate of cost increases is slowing and 29% of insurers reported using wellness programs as one way to control costs. While traditional cost... Read More
Posted by Cristie Travis at Saturday, July 28, 2012 | 0 comments

Costs of Many Preventive Services Vary Widely: What Employers Can Do

Kelly Kennedy's April 6, 2012 article in USA Today sheds light on the significant variance in the costs of preventive services, now required to be covered by insurance at 100%, not subject to co-pays or deductibles. "Over the past year, health plans and self-insured employers began paying for wellness exams — diabetes screening, mammographies, Pap smears and colonoscopies — as required by the law, without charging consumers a deductible or co-payment. But in looking at 15,000 consumers, a... Read More
Posted by Cristie Travis at Tuesday, April 17, 2012 | 0 comments

Disturbing Anti-Smoking Ads Convince Thousands to Quit

"(RNN) - Calls to a national stop-smoking line doubled and traffic to the government's anti-smoking website tripled after a hard-hitting TV advertising campaign seems to have convinced many Americans to quit the deadly habit. The Tips from Former Smokers ad campaign was launched by the Centers for Disease Control and Prevention's Office on Smoking and Health on March 19. The commercials profile former smokers and others who have been affected by second-hand smoking. The... Read More
Posted by Cristie Travis at Saturday, April 7, 2012 | 0 comments

A Must Watch: Easy Way to Explain "Bundled Payments" or "Flat Fees"

Yet another great video from BlueCross BlueShield of North Carolina, this one explains "bundled payments" or "flat fees" in a way that anyone can understand.   Read More
Posted by Cristie Travis at Wednesday, March 21, 2012 | 0 comments

We Must Start Shining the Light on Quality & Cost of Healthcare

Great little video from BlueCross BlueShield of North Carolina about how they are beginning to shine the light on the quality and cost of care for their members. We need to do this in Memphis! MBGH is helping employers move in this direction.   Read More
Posted by Cristie Travis at Wednesday, March 21, 2012 | 0 comments

Consumer Directed Health Plans Becoming Mainstream

MBGH attended the recent Memphis meeting presenting the results of the Annual Mercer National Survey of Employer-Sponsored Health Plans 2011. Although I had read the results when they were released in November 2011, at this meeting, I was particularly struck by the news about how employers are using Consumer Directed Health Plans (CDHPs) as shown by these survey results: 2011 saw the biggest year-over-year increase in CDHP offerings AND enrollment since 2007 for large... Read More
Posted by Cristie Travis at Thursday, March 15, 2012 | 0 comments

Are You Meeting Your Obligations to Nursing Mothers?

One of the highlights of MBGH's "Believe in a Healthy Memphis: the 2011 Let's CHANGE Summit" held last July in collaboration with the Healthy Memphis Common Table, the Shelby County Health Department, and Shelby County Mayor Luttrell's office, was the decision to encourage breastfeeding friendly practices in all area birth hospitals. The Shelby County Breastfeeding Coalition is taking the lead on this important initiative. Clearly the hospital and its staff play a significant role in... Read More
Posted by Cristie Travis at Wednesday, March 14, 2012 | 0 comments

Health Benefits Changes on the Horizon

Towers Watson/National Business Group on Health study finds health benefits changes are on the horizon. Although the rate of health care cost increases is expected to remain stable in 2012, employers are taking more aggressive steps to manage their rising costs and improve employee health, according to findings from the 2012 Towers Watson/National Business Group on Health (NBGH) Employer Survey on Purchasing Value in Health Care. Steps being taken focus on: Developing a... Read More
Posted by Cristie Travis at Tuesday, March 13, 2012 | 0 comments

U.S. Health Spending Growth Slows for 2nd Year in 2010

U.S. health care spending experienced historically low rates of growth in 2009 and 2010 according to the annual report of national health expenditures (NHE) from the Centers for Medicare & Medicaid Services (CMS) published in the January issue of the journal Health Affairs. Analysts at CMS report that the increase in spending for 2009 represents the lowest rate of increase in the entire 51 year history of the NHE. The low rate of growth, the data show, reflects lower... Read More
Posted by Cristie Travis at Monday, January 30, 2012 | 0 comments

Organizations Team Up to Help Physicians, Patients "Choose Wisely"

In the field of medicine, the customer is not always right, but that doesn't necessarily stop physicians from ordering tests and procedures that may not be strictly medically indicated when their patients request such tests or procedures. Recognizing this problem, the American Academy of Family Practice (AAFP) has joined with 10 other organizations in the Choosing Wisely campaign, which is designed to develop a series of evidence-based lists of medical tests, procedures and... Read More
Posted by Cristie Travis at Monday, January 30, 2012 | 0 comments

Take Steps to Reduce Your Labor & Delivery Costs

Labor and delivery account for nearly 25% of all hospitalizations for many employers, and costs associated with pregnancy and its complications are a driving factor in the rising costs of health care. The growing use of medically unnecessary interventions is increasing costs and complications among mothers and babies, with no evidence of improved outcomes. The Catalyst for Payment Reform (CPR), an independent, non-profit corporation working on behalf of large employers to catalyze... Read More
Posted by Cristie Travis at Monday, December 12, 2011 | 0 comments

IOM's Essential Health Benefits Recommendations Leave More Questions Than Answers

The IOM recommended that HHS develop an EHB package by May 2012. The high-level recommendations are as follows: 1. The EHB package should be adjusted so that the expected national average premium for a “silver” (second-lowest-price) plan is actuarially equivalent to the average premium small employers would have paid in 2014 for a typical plan. 2. The HHS Secretary should establish a framework for monitoring EHB implementation and updating that accounts for changes in... Read More
Posted by Cristie Travis at Thursday, October 20, 2011 | 0 comments

Do You Understand the Impact of the Individual Mandate?

Great article from Milliman explaining why something has to be done to address adverse selection in health reform. If it is not the individual mandate, what will it be? As Tom Snook, Principal & Consulting Actuary, Milliman Inc., says, people will operate in their own economic self-interest. If they are healthy and the cost of health insurance is high, they will not purchase health insurance, especially if it is not highly subsidized by their employer. If they are sick, they are more... Read More
Posted by Cristie Travis at Thursday, September 22, 2011 | 0 comments

IRS Releases 2012 Indexed Amounts for HSAs, HDHPs

On May 24, 2011, the U.S. Treasury Department and Internal Revenue Service (IRS) released Revenue Procedure 2011-32, which lists the 2012 indexed amounts, adjusted for inflation, for health savings accounts and high-deductible health plans (HDHPs). (In some cases, this resulted in no change from the prior year.) The following table lists the 2011 amounts and the new 2012 amounts: The Revenue Procedure is effective for calendar year 2012.  (Source: CQ HealthBeat) ... Read More
Posted by Cristie Travis at Tuesday, May 31, 2011 | 0 comments

Memphis Total Cost of Healthcare Increases Less Than National Average

The good news for Memphis is that our total cost of healthcare for a typical family of four covered by a PPO increased only 5.7% from 2010 to 2011 compared to a national increase of 7.3% during that same time period. Memphis costs are now 4.3% above the national average, down from 6% above the national average in 2010. The Milliman Medical Index looks at costs paid by the employer and the employee at a national level and at several key markets throughout the US, including Memphis. Because... Read More
Posted by Cristie Travis at Thursday, May 12, 2011 | 2 comments

MBGH is First TN Employer Group to Sign Pledge for Partnership for Patients

Memphis Business Group on Health is the first employer/employer group in Tennessee to sign the pledge to support the " Partnership for Patients ' Partnership for Patients: Better Care, Lower Costs was launched today, April 12, 2011, by HHS Secretary Sebelius and CMS Administrator Berwick along with consumer groups, industry representatives, and other key stakeholders, including the Leapfrog Group and the National Business Coalition on Health. MBGH was the first Tennessee employer group... Read More
Posted by Cristie Travis at Tuesday, April 12, 2011 | 0 comments

Deficit Panel Targets Healthcare Cost Reduction to Reduce US Debt

Just when we were all beginning to adjust to the sweeping changes in health insurance plans required by Health Reform legislation passed in March 2010, we are now bombarded by the possibility of more changes included in the Deficit Panel's recommendations to reduce US debt. Although many of these specifics may not become law, most experts believe that they will, indeed, be considered and debated since healthcare costs and their rate of increase contribute significantly to the Federal deficit.... Read More
Posted by Cristie Travis at Thursday, December 2, 2010 | 0 comments

The Double Whammy: We Still Have Unsafe, Expensive Healthcare

It doesn't take a rocket scientist to draw the conclusion that we still have unsafe, expensive healthcare in the US, and right here in Memphis, when you read the headlines of recent reports: AHRQ: Rate of Adverse Events in Medicare Cases "Disturbing" Case 34-2010: A 65-Year Old Woman with an Incorrect Operation on the Left Hand Surgery on Wrong Patients, Surgical Sites Persists, Study Finds   Top 10 Most Costly, Frequent Medical Errors These articles not only focus on the... Read More
Posted by Cristie Travis at Wednesday, November 17, 2010 | 0 comments

Milliman Survey: Even with New Contracting Approaches Rates Increase 11.7% in 2011

Milliman's 2010 Group Health Insurance Survey  found insurers estimated a 10.2% and 11.7% increase for HMOs and PPOs respectively for 2011. The survey also found that the most frequent contracting and cost control steps insurers are taking in 2011 include: Quality incentive programs Shared risk with provider networks Increased price transparency with members More aggressively tiered providers networks Reduced broker commissions Almost all of the insurers... Read More
Posted by Cristie Travis at Thursday, October 28, 2010 | 0 comments

Commercial Per Capita Costs Increase 8.7%, Far Outpacing Medicare Costs

From Business Insurance , S&P Healthcare Indices reports that for the 12-month period ending August 2010, per capita health care costs for commercial plans,including self-insured, increased 8.66% compared to an increase in Medicare per capita cost of only 5.08%. Hospital services accounted for the greatest difference between commercial & Medicare with commercial experiencing a 9.66% increase and Medicare having a 4.48% increase. Read More
Posted by Cristie Travis at Friday, October 22, 2010 | 0 comments

Sentara Healthcare Saves $3.4 Million & Improves Employee Health

A 3-year, incentive-based wellness program for the employees of Sentara Healthcare had a 6:1 return on investment, saved approximately $3.4 million in healthcare costs, and resulted in health improvement for nearly 80% of the employees that participated in the program. Major program components included: Completion of a voluntary personal health profile to identify risk factors Employees with low risk factors were awarded a $500 annual premium reduction Employees with... Read More
Posted by Cristie Travis at Wednesday, October 20, 2010 | 0 comments

Glad You Have "Most Favored Nation" Pricing? You Should Read This

Most favored nation pricing means that you (or your health plan) have the best pricing a hospital or physician practice gives any plan.On the surface, this looks good; after all, all other payors will pay more than you. However, all may not be good at all. If the price you have as the floor is a high price, then you and everyone else pays more than you really should be paying, leading to higher overall health care costs in your market. This is just one of the issues being litigated in the... Read More
Posted by Cristie Travis at Tuesday, October 19, 2010 | 0 comments


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