Ditching PPOs for Direct Contracting

From EBA

Jeff Fox, a principal and the benefits practice leader at HJ Spier in Indianapolis, Ind., is ditching PPOs in favor of direct provider contracts for his employer clients. He pairs this with self-funding to achieve substantial cost reductions over their previous preferred provider discounts, and in some cases, he helps clients band together to enter direct contracts as an employer coalition.

Fox’s partner in these undertakings is Gary Everling, the executive director for business development at Hendricks Regional Health in Hendricks County, Ind., and the Hendricks County Government and the Town of Plainfield, Ind., were his first direct contract clients.

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Amazon has Healthcare Fever: Six Symptoms You Should Recognize

By Marc Butler, Intellgize 

It’s obvious that Amazon is becoming a player in the healthcare space. And it’s making plenty of people in the industry sick.

A mere sneeze out of Seattle can give anyone in the vicinity the chills. In January, Amazon announced a partnership with Berkshire Hathaway and JP Morgan Chase to form an independent health care company for their employees. Despite a lack of details, the news sent the stocks of United Health and Anthem plummeting by more than 5 percent. And that’s just one of the entry points that Amazon has established into our ripe-for-disruption healthcare industry. Here are six initiatives that Amazon has going right now, all of which signal a serious commitment to break into – if not break up – the industry:

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Leading the HSA Revolution: How to help Employers see the Value of HSAs

From BenefitsPro

After 14 years in the marketplace, why are HSAs not more widely used by employers and individuals? Possibly employees and employers have some questions that aren’t being answered. Here’s how to help. (Photo: Shutterstock)

Roy Ramthun (also known as “Mr. HSA”), founder and president of HSA Consulting Services and Chad Wilkins, president of HSA Bank in Sheboygan, Wis. are quoted in this article.

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Web-Based Interventions Can Improve Parents’ Attitudes About Benefits of Vaccination

DENVER — Providing parents accurate clinical information about vaccines through a website, and providing access to vaccine experts can help improve parents’ attitudes about vaccinating their children, according to a Kaiser Permanente study published today in the American Journal of Preventive Medicine.

The 1,093 study participants, who were recruited during pregnancy, were randomly assigned to one of three study groups: website with vaccine information and interactive social media components (or VSM); website with vaccine information only (or VI); or usual care only (UC).

The study team created a website that presented easy-to-understand information on the risks and benefits of vaccination, recommended vaccination schedules, vaccine ingredients and vaccine laws. The investigators also built an interactive social media component within the website that included an expert-moderated blog, discussion forum, chat room and an “Ask a Question” portal where parents could ask experts questions about vaccines. Continue reading


PITTSBURGH, Pa. (May 4, 2018) — Highmark Inc. has entered into a six-year partnership with Sharecare, the digital health company helping people manage all their health in one place, to exclusively offer innovative, personalized health and wellness solutions to its employer group customers in Pennsylvania, Delaware, and West Virginia. Additionally, beginning January 1, 2019, Highmark members will have access to Sharecare’s personalized mobile and web-based platform that will help them better manage and understand their health, and provide timely and actionable steps to improve it, no matter where they are in their health journey.

“Consumers are more active in their own health care, but they are challenged with credible real-time information to help with health care decisions,” said Dr. Charles DeShazer, senior vice president and chief medical officer for Highmark. “Sharecare is laser focused to meet consumer expectations and ensure an exceptional member experience, and further sets its platform apart with personalized articles, videos and health content from trusted sources like the National Institutes of Health, American Heart Association and Centers for Disease Control — all through the smartphone and in the palm of your hand.”

Sharecare’s real-time data and personalized messages are also beneficial to employers, who are looking for ways to keep employees engaged, healthy and productive. Continue reading

3 Policy Changes to Increase HSA Access

From ThinkAdvisor

As health care costs continue to rise, health spending accounts are gaining momentum as vital tools that help many Americans save money by using pretax dollars to pay for health-related expenses. Flexible spending accounts (FSAs) and health savings accounts (HSAs) are two of the most common such vehicles. These consumer-driven spending accounts are particularly useful in conjunction with high-deductible health plans, which are becoming more common among workplace benefits offerings.

As the use of these accounts increases, legislative changes are needed in order to make them effective and accessible to more Americans. Here are three regulatory updates currently on the table to encourage broader use of FSAs and HSAs among American employers and employees:


1. Repeal or amend the “Cadillac Tax”

The excise tax on high-cost employer-provided health plans (also known as the “Cadillac Tax”) was included in the Affordable Care Act to discourage employers from providing excessively rich health benefits at taxpayers’ expense. It places a 40% tax (paid by the employer) on the cost of health coverage that exceeds certain threshold amounts.

The Cadillac Tax has unintended consequences for HSAs and FSAs. In particular, the inclusion of individual employee contributions to these accounts in the calculation of the tax threshold creates a significant disincentive for employers to offer these benefits, for fear of triggering the excise tax.

An amendment to repeal the Cadillac Tax passed the Senate in July 2017, but the corresponding bill has yet to pass the House of Representatives. On Jan. 22, Congress passed and President Donald Trump signed into law a two-year delay on the Cadillac Tax as part of the federal funding bill to end a partial government shutdown. The tax remains delayed until 2022, but a two-year delay has little impact on the many employers who must make decisions about their benefits programs three to five years in advance. In order to maintain and expand the availability of FSA and HSA accounts for working families, Congress must repeal the Cadillac Tax entirely, or at the very least pass legislation to exempt individuals’ contributions to these accounts from the calculation of the tax threshold.

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Millennials: Here’s what to consider before you dive into a health savings account

From CNBC:

Financial advisors say picking a high-deductible health plan with a health savings account can be a smart way to save for retirement (and future health-care costs).

The high-deductible plan premiums are less expensive, and the associated health savings account has a triple tax advantage: Contributions are either pretax or tax-deductible, typically grow tax-free and can be withdrawn without incurring taxes when used toward qualified medical expenses.

“There’s a huge opportunity if you’re putting away a few thousand dollars a year in your 20s and 30s, what that can grow to,” said certified financial planner Sophia Bera, founder of Gen Y Planning.

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Self-Insurance Is Just the Start, Say Health Plan Innovators

From SHRM:

Employers are not being bold enough with their self-insurance strategies, said health plan trendsetters speaking at panel discussions at the recent 2018 World Health Care Congress in Washington, D.C.

Much of the thinking behind common health plan design changes is misguided, said health care broker and consultant David Contorno, president of Lake Norman Benefits. “Deductibles didn’t work, so we’ve made them higher. Networks didn’t work, so we’ve made them narrower. It’s backward logic.”

A change that the experts wanted to see is greater price transparency for health care services. “Any CEO in the country can quickly look up what they pay for paper clips, but when you ask the same question about a back surgery, they don’t know the cost,” said Lee Lewis, innovative practice lead at benefits broker Arthur J. Gallagher. “There are about 350 procedures that make up 90 percent-plus of all the health care dollars we spend. It’s not that hard to figure out the cost of 350 things” and then use plan incentives to encourage enrollees to select high-quality, cost-effective providers.

To that end, consider incentives that encourage employees to use health care centers of excellence, which are facilities that specialize in certain procedures with a record of better-quality outcomes at lower costs. “It’s only 35 miles for most people to drive to a center of excellence,” said health care futurist and author Josh Luke, former CEO of Avanti Hospitals. “That’s less than many people drive to work each day.”

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Education Key to HDHP and HSA Engagement

From PlanSponsor.com:

Just 13% of the 1,100 respondents to WEX Health’s first-ever Clear Insights report identified a health savings account (HSA) as the employer benefit that provides the most pre-tax savings.

In addition, more than half (54%) were not aware that they could invest their HSA funds in stocks, mutual funds and other investment vehicles. And, three-quarters of respondents see their HSA as a way to pay for health care expenses this year, which indicates they may not be aware that funds can be carried over into the next year. WEX Health says all these findings add up to a significant opportunity for further education on the triple-tax advantages of HSA accounts.

More than three-quarters (82%) of those who participate in high deductible health plans (HDHPs) either somewhat or strongly agree that managing their health care spending account helps them make smarter health decisions. The survey found the ways to motivate employees the most to access resources and make better health care choices are financial incentives (64%), emails (43%), online tools and resources (38%) and online ability to track employees’ health care goals (33%).

The most challenging part respondents cited in using their HSA was making sure to have enough funds set aside to cover deductibles (29%) and figuring out how much money to put in the account overall (21%).

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