Reference-based pricing: What about balance bills?

Posted by Emily Kubis on Wed, May 09, 2018 @ 08:05

Solutions for employers

Reference-based pricing is a new way for self-insured employers to pay for employee’s medical costs. Instead of using a traditional insurance carrier’s network, employers simply pay hospitals a percentage in excess of Medicare’s reimbursement rate for the same service.

Why would employers adopt this plan?  Generally, the benefit that insurers provide to employers are their network discounts for services. But with healthcare prices skyrocketing, employers are questioning whether this strategy provides enough value.

(More: How a 40-employee group saved $100,000 with reference-based pricing.)

Here’s how hospital pricing usually works.

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Tags: health insurance small employers, Self-Insured, self-funded, reference based pricing, self-insurance, balance billing

Group benefits for manufacturers

Posted by Emily Kubis on Fri, May 04, 2018 @ 07:05

Manufacturers face challenges in building benefits plans

Do you have the right strategy for your group health plan? Manufacturers face particular challenges when it comes to finding the right approach to building a sustainable benefits package.

Bernard Health has a decade of experience working with manufacturers, and we offer a suite of innovative products and services to help your employees make the best choices when it comes to healthcare.

Here are three areas of need manufacturers face when it comes to benefits. For more, download the free “Benefits Guide for Manufacturers.”

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Tags: health insurance small employers, group benefits, employer digest

Tips for optimizing an HSA benefits strategy

Posted by Emily Kubis on Wed, May 02, 2018 @ 08:05

Health Savings Account use continues to rise

A new study from the National Center For Health Statistics shows significant growth in the number of consumers with HSA-eligible plans and consumers with HSAs, though opportunities for increased adoption remain.

The study, which covered the first nine months of 2017, found that nearly half of privately insured consumers under the age of 65 have high-deductible, or HSA-eligible, health plans.

Eighteen percent of those enrollees also have a Health Savings Account, though a quarter of consumers with HSA-eligible plans do not yet have a Health Savings Account.

These percentages are on the rise. The percentage of people enrolled in HSA-eligible plans has increased almost 18 percent since 2010, and the percentage of people with HSAs has more than doubled since 2010.

Does your organization struggle with HSA adoption? Many do. Here are three challenges and solutions to an optimized HSA-eligible benefits strategy:

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Tags: HSAs, health savings accounts, employers, health insurance small employers, employer digest

Group benefits for construction companies

Posted by Emily Kubis on Fri, Apr 27, 2018 @ 08:04

Construction companies face challenges in building benefits plans

Do you have the right strategy for your group benefits plan? The construction industry faces particular challenges when it comes to finding the right approach to building a sustainable benefits package.

Bernard Health has a decade of experience working with the construction industry, and we offer a suite of innovative products and services to help your employees make the best choices when it comes to healthcare.

Here are three areas of need construction companies face when it comes to benefits. For more, download the free “Benefits Guide for the Construction Industry.”

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Tags: health insurance small employers, group benefits, employer digest

Employers—here’s how to adopt HR tech

Posted by Emily Kubis on Mon, Apr 16, 2018 @ 09:04

Broker-supported benefits software is better than seeking a solution on your own

According to analytics firm Larocque Inc., venture capital investments in HR tech surpassed $1 billion in 2017, particularly focusing on talent acquisition, followed by HCM (human capital management) tools to manage core HR functions.

These tools include benefits, time tracking, applicant tracking and more.

The takeaway is that small and mid-sized employers are on the cusp of a huge move to administer HR and benefits online.

But how do you know which type of solution is right for your organization, and where can you find the right solution?

The first place to start is by asking your broker what solutions they can provide or recommend. Many brokers nationwide license software tools to streamline benefits and HR administration. Bernard Health clients have access to BerniePortal, an all-in-one benefits and HR platform.

There are a few benefits of a broker-supported platform:

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Tags: broker software, health insurance brokers, employers, solutions for employers, health insurance small employers, employer plans, broker, employer digest, HR tech

Group benefits for medical practices

Posted by Emily Kubis on Fri, Apr 13, 2018 @ 09:04

Medical practices face challenges in building benefits plans

Do you have the right strategy for your group health plan? Medical practices face particular challenges when it comes to finding the right approach to building a sustainable group benefits package.

Bernard Health has a decade of experience working with medical practices, and we offer a suite of innovative products and services to help your employees make the best choices when it comes to healthcare.

Here are three areas of need medical practices face when it comes to benefits. For more, download the free “Benefits Guide for Medical Practices.”

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Tags: health insurance small employers, group benefits, employer digest

What is the Medical Loss Ratio?

Posted by Emily Kubis on Fri, Apr 06, 2018 @ 08:04

Is the MLR driving up employer healthcare costs?

A piece of the Affordable Care Act that seeks to cap insurer profits may be driving employer healthcare costs in some cases.

The ACA’s Medical Loss Ratio intended to cap the profits of insurance companies by requiring them to pay out 80 percent of what they collect in premiums, leaving 20 percent for administrative costs, marketing and profit.

The reasoning behind this was to put eight out of every ten insurer dollars toward claims, as opposed to other parts of their business.

However, this also means the maximum profit insurers can collect is 20 percent of premiums. As a result, the avenue to profit growth is to increase premiums altogether, especially for those not surpassing the 80 percent threshold.

Employers are left to question whether insurers are best positioned to help employers lower medical claims, and what really drives annual premium increases of 10 percent, 15 percent, 20 percent or more.

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Tags: health insurance small employers, Self-Insured, healthcare costs, Medical Loss Ratio, employer digest, employee benefit adviser, self-funded, reference based pricing, self-insurance, network discount

What is an insurance network discount worth?

Posted by Emily Kubis on Wed, Apr 04, 2018 @ 09:04

Consider the value of insurance discounts

Some self-insured employers are adopting new strategies to pay for their group benefits plan. These plans, including direct contracting with hospitals or reference-based pricing, typically do not use a traditional insurance network.

Many employers are finding they can obtain better value for the services they pay for by either negotiating with the hospital directly, or by paying an excess of Medicare’s reimbursement rate.

Why would employers want to adopt these strategies? Generally, the benefit that insurers provide to employers are their network discounts for services. But with healthcare prices skyrocketing, are employers getting the most value through this set up? Let’s look at how it typically works. 

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Tags: health insurance small employers, Self-Insured, employer digest, employee benefit adviser, self-funded, reference based pricing, self-insurance, network discount

Self insurance on the rise

Posted by Emily Kubis on Wed, Mar 28, 2018 @ 06:03

Rising healthcare costs make self-insurance more attractive

A new study from Arthur J. Gallagher & Co. reports that self-insurance is on the rise across the employer spectrum, including lower midsize, upper midsize and large employers.

The rate of employers self-insuring has increased between 8 and 10 percent since 2016, the study found.

This trend is expected to continue as costs associated with traditional, fully-insured plans become prohibitively expensive, especially for small and midsize employers.

The big benefit of self-insurance is the savings potential. Because employers pay the claims, they reap the benefit of low-claim years. Additionally there are also blended options, where employers can take on less risk and still benefit in low-claim years while minimizing risk in high-claim years.

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Tags: health insurance small employers, Self-Insured, employer digest, employee benefit adviser, self-funded, self-insurance

How employees are overpaying for drugs through prescription “clawbacks”

Posted by Emily Kubis on Mon, Mar 26, 2018 @ 06:03

Study shows impact of 'gag clauses' on prescription prices

According to a new study published by USC Schaeffer, almost a quarter of filled pharmacy prescriptions had a patient copay that exceeded the actual cost of the drug.

In other words, 23 percent of consumers would have paid less for their prescription if they had not used their insurance at all, a practice called a “clawback.”

“The term ‘copayment’ suggests that the patient and insurer are sharing the total cost of the drug,” the study said. “On some prescription claims, the total cost of the drug is less than the patient’s copayment, and the insurer or pharmacy benefit manager keeps the difference in what is known as a ‘clawback.’”

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Tags: prescription medications, expensive prescriptions, health insurance small employers, prescription costs, employer digest

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