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Category: Health Plans

MBGH Joins the National Alliance in a New Vision for Specialty Drugs Marketplace

To drive collaboration to control cost, reduce waste and maximize effectiveness of specialty drugs, the non-profit National Alliance of Healthcare Purchaser Coalitions (National Alliance) has developed stakeholder guidelines and an engagement framework. “Specialty drugs are the fastest growing area of spend for employers today,” said Mike Thompson, National Alliance president and CEO. “While these new drugs are truly innovative and important, the specialty drug... Read More
Posted by Cristie Travis at Wednesday, April 5, 2017 | 0 comments

Potential Insurance Company Mergers Could Limit Employer Choices

Source: Morning Consult 6/21/15 Update: Cigna Rejects Anthem's $47 billion offer. Read why and more about other possible mergers in the latest NY Times article. Are these possible mergers good or bad? Well, the answer is "depends". They would certainly limit employer choices as well as people purchasing individual insurance or insurance through the exchanges. On the other hand, larger insurance companies may be able to negotiate more favorable financial arrangements with the health... Read More
Posted by Cristie Travis at Friday, June 19, 2015 | 0 comments

Only 7% of Employers Use Objective Quality Information to Select Health Plans

A recent Associated Press-NORC Center for Public Affairs Research (AP-NORC) survey of employers found that 60% of employers think health plan quality ratings are important but employers employers lack familiarity with health quality information—particularly, objective data on the quality of health insurance plans. Just 7 percent of employers that offer health insurance use objective quality information from sources tested in the survey; 89 percent do not use or are unfamiliar with any of the... Read More
Posted by Cristie Travis at Monday, December 22, 2014 | 0 comments

National Commission Calls for Changes in Physician Payment Methods

On March 4, 2013, the National Commission on Physician Payment Reform  issued a report detailing a series of recommendations aimed at reining in health spending and improving quality of care by fundamentally changing the way doctors are paid. The Commission’s 12 recommendations provide a five-year blueprint for transitioning to a blended payment system that will yield better results for both public and private payers, as well as patients.Highlights from the recommendations include: 1.... Read More
Posted by Cristie Travis at Monday, March 11, 2013 | 0 comments

Catch Up on What's Happening with Health Insurance Exchanges

Wonder what's going on with Health Insurance Exchanges, especially in Tennessee? The answer is that a lot has to happen very quickly for exchanges to be ready for open enrollment in the fall of 2013. HHS has extended the deadline for states to indicate their intention to establish a state-sponsored exchange until December 14, 2012. Click here to read Tennessee Governor Haslam's official response to this new deadline. Plus, as you know, employers have obligations to notify their... Read More
Posted by Cristie Travis at Saturday, November 3, 2012 | 0 comments

Retirees Are Often the First To Purchase Coverage Through Private Exchanges

From the National Business Coalition on Health: Kaiser Health News reports that in the past 20 years, the number of companies that provide retiree health coverage has dropped dramatically, leaving seniors with the difficult task of choosing among a variety of plans to supplement their Medicare benefits. It is a choice that can be confusing and has large financial implications. But a move by some employers is softening the blow. They are contracting with ... Read More
Posted by Cristie Travis at Friday, October 19, 2012 | 0 comments

Two Major Employers Embrace Private Health Insurance Exchange

From the National Business Coalition on Health: According to Employee Benefit News, in a move that could herald a sea change in health benefits, Sears Holdings Corp. and Darden Restaurants, Inc will begin allowing employees to purchase health insurance through a private insurance exchange in 2013. Around 90,000 Sears employees and some 45,000 Darden employees will be eligible to purchase insurance through the exchange, which will be operated by Aon Hewitt. Starting Jan. 1, employees at the... Read More
Posted by Cristie Travis at Saturday, September 29, 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

How Long Will We Accept Preventable Medical Mistakes?

My heart breaks and then I get mad when I read about preventable medical mistakes, aka medical errors, causing so much pain and even loss of life for patients! When you read the full article below, you will see that in California (CA) at least 8 of the 14 hospitals cited have had penalties levied against them before. Why are these multiple-offenders allowed to stay open? Why do health plans continue to contract with these hospitals? Why do doctors continue to refer patients to these... Read More
Posted by Cristie Travis at Friday, August 31, 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

New, More User-Friendly Health Reform Website from American Benefits Council

From the National Business Coalition on Health: The American Benefits Council, an important strategic partner of NBCH, has announced its new, more user-friendly website. The Health Care Reform issue page is now divided into its component pages, covering the wide variety of health reform issues addressed by the Patient Protection and Affordable Care Act (PPACA). These individual topics are: § Employer Shared Responsibility § Market Reforms & Adult Child/Age-26 Coverage §... Read More
Posted by Cristie Travis at Friday, May 4, 2012 | 0 comments

Physician Groups Identify Tests and Procedures That are Often Not Necessary

Nine physician organizations have each identified five tests or procedures that may be overused or unnecessary as part of the Choosing Wisely campaign led by the ABIM Foundation, with Consumer Reports, in an effort to improve health care quality and patient safety. Patient advocates are calling the move a significant step toward improving the quality and safety of health care. As the nation increasingly focuses on ways to provide safer, higher-quality care to patients, the overuse... Read More
Posted by Cristie Travis at Friday, April 6, 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

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

Employers Interested in Exploring a Corporate Health Exchange Model

From Aon Hewitt: Employers Interested in Exploring a Corporate Health Exchange Model, Says Aon Hewitt  --  March 23 marks two years since Health Care Reform legislation passed. During this time, many employers have re-examined the way in which they provide health care benefits to employees. While state exchanges will not be available to employers with more than 100 employees until at least 2017, organizations are exploring alternate health care models, such as Corporate... 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

ADP Survey: 40% of Employees Don't Understand Their Benefits

According to a recent article by Lisa Gillespie in Employee Benefit News... A new ADP survey shows a wide gap between the goals and reality of how employees understand their benefit plans. Eighty percent of human resources decision-makers believe it's important for employees to fully understand their benefit options, yet they estimate only about 60% of their own employees do – a finding with serious implications for how companies communicate one of the most important parts of... Read More
Posted by Cristie Travis at Monday, January 30, 2012 | 0 comments

Catalyst for Payment Reform Releases Model Contract for Employers

From the National Business Coalition on Health : The Catalyst for Payment Reform released a tool ( see model health plan contract language ) to unite employers and other health care purchasers around the shared goal to make 20% of health care payments based on value by 2020. This tool will help MBGH with our efforts to reform payment in the greater Memphis area. The model contract highlights immediate opportunities to reform how health plans pay doctors and hospitals. Together... Read More
Posted by Cristie Travis at Thursday, January 19, 2012 | 0 comments

TN Plans Encouraged to Give "Good Driver Discounts"

Proposed recommendations for the Tennessee Health Insurance Exchange encourage health plans and employers to establish expectations about personal responsibility and engagement through benefit designs in the Exchange.   The wellness program could provide some sort of "good driver discount" in the form of a lower premium or other incentives to those enrollees who satisfy these standards. Having the exchange plans offer these incentives will make it easier for larger employers too!... Read More
Posted by Cristie Travis at Monday, December 12, 2011 | 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

Benefits Basics: MBGH Offers New Member Benefit in 2012

In 2012, MBGH is offering a series of Benefits Basics webinars, designed to "fill the gap" for educational programming geared toward new hires, where other programs are not readily available from reliable training sources (such as ISCEBS or WEB). These "101" level classes are for MBGH members-only and oriented toward new benefits staff, or individuals in need of refresher information.  Programs will be taught by seasoned benefits professionals and are being sponsored by the Health... Read More
Posted by Cristie Travis at Friday, December 9, 2011 | 0 comments

How Will a TN Insurance Exhcange Impact Employers?

Get the answer by reading the full document (or the Executive Summary ), “Best Alternatives to a Federal Insurance Exchange in Tennessee”, just issued by the State of Tennessee Insurance Exchange Planning Initiative (the Initiative). The report provides a comprehensive analysis of the governance, structure, processes of an insurance exchange and suggests how Tennessee may want to address the issues to ensure a stable and competitive market in the state. The Small Business... Read More
Posted by Cristie Travis at Monday, October 31, 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

If I were King....

If I were King, and could wave my magic wand, my three wishes would be (ooops, I think I am mixing metaphors, oh well): Engage my employees as partners with me in the quality and cost of their health benefits. I would Implement a benefit design similar to the State of Tennessee , offering lower payroll deduction for premium co-shares, lower deductibles, lower co-pays, and lower co-insurance in exchange for employees and their families taking an HRA, getting their biometrics, and agreeing... Read More
Posted by Cristie Travis at Friday, September 23, 2011 | 0 comments

NBCH Hospital Patient Safety Action Brief Details Actions for Employers

The National Business Coalition on Health's (NBCH) Action Brief on Hospital Patient Safety, lays out the issues, details how health plans across the country are or are not working to improve safety, and details actions employers can take to have an impact on patient safety for their employees. 2011 eValue8 results were used to track how health plans are or are not working to improve safety. MBGH is an active participant in the eValue8 process and this year both BlueCross BlueShield of... Read More
Posted by Cristie Travis at Thursday, September 22, 2011 | 0 comments

State Governments Requiring More from Employees in New Health Benefits

Maybe it's time for the private sector to look at how state governments are ratcheting up the requirements for employees to get health benefits and follow suit. Whether it is called the Health Enhancement Plan, like it is in Connecticut, or the ParTNers for Health Plan, as it is in Tennessee, state governments are offering new plans that offer lower employee costs (through payroll deductions, deductibles, co-pays, co-insurance) in exchange for employee engagement in health risk... Read More
Posted by Cristie Travis at Thursday, September 22, 2011 | 0 comments

McKinsey Projects 30% of Employers Will Drop Health Benefits

Major findings from McKinsey's early 2011 survey of 1,300 employers include: Overall, 30 percent of employers will definitely or probably stop offering employer-sponsored insurance (ESI) in the years after 2014. Among employers with a high awareness of reform, this proportion increases to more than 50 percent, and upward of 60 percent will pursue some alternative to traditional ESI. At least 30 percent of employers would gain economically from dropping coverage even if... Read More
Posted by Cristie Travis at Monday, June 6, 2011 | 1 comments

Delbanco believes the healthcare payment system needs “CPR”

Who better to help you beat the health reform blues than Suzanne F. Delbanco, PhD., executive director of Catalyst for Payment Reform (CPR). Delbanco is joining Peter Hayes , Principal for Healthcare Solutions and formerly with Hannaford Supermarkets, and John Moses, PhD, thought leader for behavior change and measurement with AON Hewitt, as national keynote speakers at MBGH September 8, 2011 Annual Conference, “Got the Health Reform Blues?” .   CPR is working to... Read More
Posted by Cristie Travis at Monday, May 16, 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

Broker Commissions: In or Out of Medical Loss Ratio Calculations?

Health Reform Update from the National Business Coalition on Health The National Association of Insurance Commissioners (NAIC) is considering whether to endorse legislation that would remove broker and agent commissions from the medical loss ratio, a calculation that could give consumers valuable insights about the proportion of their premiums spent on health care costs compared with administrative expenses and salaries. Removal would have far-reaching implications for the... Read More
Posted by Cristie Travis at Wednesday, May 11, 2011 | 0 comments

MBGH Recognizes Two Health Plans & Five Hospitals For Improving Cost & Quality

The Memphis Business Group on Health (MBGH), Memphis’s only non-profit organization focused on employee health and wellness issues from the employers’ perspective, recognized two health insurance companies and five regional hospitals for their progress toward improving health care quality in the region in 2010. BlueCross BlueShield of Tennessee and UnitedHealthcare of Tennessee were recognized for scoring in the top 15% on several aspects of eValue8, the leading evidence-based... Read More
Posted by Cristie Travis at Friday, April 29, 2011 | 0 comments

MBGH Talks with MBQ About How State Health Insurance Exchanges Impact Businesses

Cristie Upshaw Travis, CEO of Memphis Business Group on Health, talked with Richard Banks, blogger for the Memphis Business Quarterly's Business Minded Blog, about a critical component of healthcare reform, state health insurance exchanges, and how exchanges will impact Memphis businesses. Read the complete post to learn the basics about exchanges. Get information about how Tennessee is planning to implement exchanges by clicking "Health Insurance Exchange" tag at the end of this post... Read More
Posted by Cristie Travis at Tuesday, January 18, 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

Tennessee Health Plans Rank in Top 15% Nationally on eValue8

The National Business Coalition on Health released its national eValue8 2010 report "Engage...Focus...Improve"  on November 16, 2010. The report provides a snap shot of health plan performance on key elements including consumer engagement, provider measurement, pharmacy management, prevention/health promotion, chronic disease management, behavioral health management. This year, for the first time, eValue8 also measured plan performance in reducing waste and inefficiencies in the delivery... Read More
Posted by Cristie Travis at Thursday, November 18, 2010 | 0 comments

MBGH Hosts Successful Value-Based Insurance Design Webinar

MBGH hosted a successful Value-Based Insurance Design webinar on Thursday, November 4,2010 with A. Mark Fendrick, MD, co-Director of the Center for Value-Based Insurance Design at the University of Michigan. MBGH  has been working with Mark since February 2008, when MBGH launched our value-based benefits initiative to educate our members and Memphis-area employers on the principles of value-based benefits and to assist them in identifying opportunities to deploy those principles in... Read More
Posted by Cristie Travis at Thursday, November 4, 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

Tennessee Starts to Evaluate Health Insurance Exchanges

Should the state of Tennessee establish its own health insurance exchange or tap into the national, federal exchange? That is the question being considered by the State of Tennessee under a $1 million grant from the federal government. I attended the "kick-off" meeting on October 22, 2010 for Tennessee's evaluation of the whole health insurance exchange issue. About 200 of us gathered in the central Nashville library to hear about the proposal TN had made for planning grant funds from the... Read More
Posted by Cristie Travis at Saturday, October 23, 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

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

MBGH Releases 2010 eValue8 Report on TN Health Plan Performance

MBGH released its 2010 eValue8 report on Tennessee Health Plan Performance at the MBGH Annual Conference on September 9, 2010. This annual report is prepared in conjunction with HealthCare 21, the business coalition in middle & east Tennessee. Click here for a copy of the report. This year, MBGH reports on the progress these health plans have made collectively in the past three years as well as each plan's specific progress. Although there has been good improvement in the areas of... Read More
Posted by Cristie Travis at Monday, September 27, 2010 | 0 comments


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