Rebecca Moore writes in PlanSponsor that, “generally, a relatively small number of plan members drive a large majority of the cost. She notes that according to Mercer’s database containing approximately 1.6 million members, on average the sickest 6% of an employer’s population represents 47% of the total allowed medical and pharmacy spend.
Mercer says high touch, nurse-centered care coordination can often produce the best possible health outcomes and as cost-efficiently as possible.
Shandon Fowler, principal and owner of a benefits and healthcare strategy and communication consultancy, wrote in EBA that “President Trump wants to allow for HRAs to be used for non-group coverage to employers of all sizes, not just small employers. “
“If regulatory language makes the same approach for small businesses available to businesses of any size, broker and consultants should view this as an industry-redefining disruption.”
Fowler sees this as a real game-changer writing, “Never before has there been a vehicle for large employers to send employees to the individual market and maintain the tax advantage of paying for employee health coverage. And never before have employees stood to potentially pay less on the open market than for employer coverage, thanks to ACA subsidies.”
When insurance plans charge patients less for the medicines that help them most, patients are more likely to take them, according to a new article.
Taking a medicine every day in the hopes that it will prevent some long-range potential health catastrophe—like a heart attack or kidney failure—isn’t easy.
Many people skip doses, or don’t refill their prescriptions on time, or at all. And plenty of studies have shown that the more patients have to pay for those prescriptions, the less likely they are to take them as directed.
In a new article in Health Affairs, researchers report a “value-based insurance design” approach led patients to fill their prescriptions more often.
Today’s feature story in the AIS Daily reports that Humana Inc. is testing a new retail-based primary care approach with Walgreens. Through a joint effort, Humana subsidiary Partners in Primary Care (PiPC) will furnish primary care and other services in two retail spaces in the Kansas City, Mo., area beginning this fall.
The story says that “The “neighborhood” approach will feature “health navigation” through which Humana representatives will be available in the stores to assist seniors in accessing numerous health-related services.”
This harks back to earlier times when Humana also owned hospitals and placed nurses in dedicated spaces within them to help seniors navigate health services, insurance, and Medicare claims filing. It was called the Humana Seniors Association and proved to be a successful integration that fostered customer loyalty.
AIS Subscribers may read the in-depth article online.Learn more about subscribing to AIS Health’s publications.
Roundstone, a firm that says its mission is to limit the annual increase in an employer’s health benefit cost to a level below inflation, has created a Cost Saving Investigators (CSI) Team.
This team of experts will review claim data and provide actionable insight into an employer’s health care spend. Its objective is to help employers identify and realize cost saving opportunities.
“Employers’ health benefit costs are not only a top 3-line item expense, but the expense is growing 5 to 7 times faster than inflation,” says Roundstone President Mike Schroeder. “We created the Roundstone CSI Team to help employers implement the most efficient purchase of health care for their employees.”
Emily Payne writes in BenefitsPro that fueled by a new round of funding, startup Bind is planning to test-drive its on-demand health care model with a handful of Fortune 500 companies.
Payne states that. “Insurance startup Bind is incredibly confident in the expansion of its on-demand health insurance platform, which offers consumers a core set of health care benefits, as well as the option to add coverage for specific procedures as the need arises.”
Basically, the model, which is used by self-insured employers, separates common and routine procedures from big-ticket surgeries.
Mike Stankiewicz writes in Fierce Healthcare that Highmark’s value-based payment program saved the insurer more than $260 million within its first year, continuing an industry trend.
Stankiewicz says the nonprofit insurer announced on Tuesday its payment arrangement program for primary care physicians reduced hospital readmissions by 16% last year, which potentially saved $224 million.
The potential savings were generated through claims data from members who saw a physician in the True Performance Program versus those that did not participate. Members that saw physicians int he program had 11% fewer ED visits.
In separate article Jay Green writing for Carin’s Detroit Business notes that hospitals and physicians can do only so much to lower health care costs. It is up to health insurers to pass on those savings to policyholders in the form of lower premiums and cost sharing.
Greene writes that this point was made by Robin Damschroder, CFO of Henry Ford Health System, at last month’s Healthcare Financial Management Association conference in Chicago. She was talking about the use of value-based contracting and the efforts Henry Ford has made over the years to lower per-patient costs.
Forbes has published an article by Martin Trussell, Executive Director of ECFC, that explains how a Health Savings Account (HSA) can be an essential part of an organization’s benefits package, offering many advantages to employees.
“Today, retirement readiness not only includes savings needed to meet daily living expenses but also preparations for the expenses of rising medical costs. Unlike earlier generations, most workers retiring now and in the future will not have an employer-sponsored health plan to help them absorb healthcare costs not covered by Medicare.” – Martin Trussell
Trussell explained, “One feature of an HSA that many overlook is that money in the account can be accumulated and put to work in an investment account offered by most HSA custodians. A wide array of stocks, bonds and mutual funds are generally available through such a brokerage account. These offerings are beneficial for those wanting to establish a secure retirement.”
MINNEAPOLIS — Devenir, a thought leader in the HSA investment marketplace, has released a white paper Viewpoint exploring best practices for HSA investments & menu design.
In a press release, Devenir notes that widespread interest has put HSA investments, an important aspect of HSAs, in the spotlight. Several recent reports, publications and articles have featured HSA investing as a promising tool for improving health and wealth. While these reports have often made compelling points and offered insight, most have viewed HSAs through external lenses and failed to capture important nuances of the HSA market. HSAs differ from 401(k)s and other more traditional retirement accounts in a number of ways. By offering best-practice marketplace conventions, stakeholders can form more comprehensive and healthier assessments of the HSA investment landscape.
Highlights from the Viewpoint include:
Menu Design: Well-designed investment menus typically offer broad asset class coverage that provides for various HSA strategy objectives.
Investment Quality: Comparing performance and a holistic approach to evaluating cost.
Plan Design: Implementing menu changes in the HSA space & plan features in demand
“Since HSA investments have come into the spotlight, we felt it made sense to share some of the insights we’ve gathered over 14 years of experience in the HSA marketplace,” said Zach Haas, lead author of the white paper and investment analyst at Devenir.
The full version of the Viewpoint is available exclusively to Devenir’s clients
Amazon (NASDAQ:AMZN) and PillPack today announced on Thursday that they have entered into a definitive merger agreement under which Amazon will acquire PillPack. PillPack is a pharmacy designed to provide the best possible customer experience in the U.S. for people who take multiple daily prescriptions. PillPack delivers medications in pre-sorted dose packaging, coordinates refills and renewals, and makes sure shipments are sent on time.
Image: Shutterstock
“PillPack’s visionary team has a combination of deep pharmacy experience and a focus on technology,” says Jeff Wilke, Amazon CEO Worldwide Consumer. “PillPack is meaningfully improving its customers’ lives, and we want to help them continue making it easy for people to save time, simplify their lives, and feel healthier. We’re excited to see what we can do together on behalf of customers over time.”
“PillPack makes it simple for any customer to take the right medication at the right time, and feel healthier,” said TJ Parker, co-founder and CEO of PillPack. “Together with Amazon, we are eager to continue working with partners across the healthcare industry to help people throughout the U.S. who can benefit from a better pharmacy experience.”
Completion of this transaction is subject to regulatory approvals and other customary closing conditions. The parties expect to close the transaction during the second half of 2018.
About Amazon
Amazon is guided by four principles: customer obsession rather than competitor focus, passion for invention, commitment to operational excellence, and long-term thinking. Customer reviews, 1-Click shopping, personalized recommendations, Prime, Fulfillment by Amazon, AWS, Kindle Direct Publishing, Kindle, Fire tablets, Fire TV, Amazon Echo, and Alexa are some of the products and services pioneered by Amazon. For more information, visit www.amazon.com/about and follow @AmazonNews.
About PillPack
PillPack is a pharmacy designed to provide the best possible experience for customers. For people who take multiple daily prescriptions, PillPack offers pre-sorted dose packaging, home delivery, and a commitment to customer service. These features help customers take medications as prescribed, which has been shown to improve health outcomes and lower costs. PillPack holds pharmacy licenses in all 50 states, has URAC and VIPPS accreditation, is an in-network pharmacy with most PBMs, including major Medicare Part D plans, and has built a proprietary set of software systems and tools called PharmacyOS. For more information visit www.pillpack.com.
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