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There was quite a stir in the healthcare industry – and to our clients – when HHS released a proposed rule aimed at eliminating rebates from pharmaceutical companies to PBMs in Medicare Part D and in Medicaid managed care organizations. Will manufacturers unilaterally lower the list prices? What’s the impact on premiums? More>>


Recent legislative events are taking aim at price transparency, including an executive order by President Trump on healthcare price transparency. Read our guest blog by our partners, Healthcare Bluebook, for their take on the recent healthcare price transparency regulatory action.
 


What happens when an employee receives a bad call about their health? If they find out they have a serious – even catastrophic – health condition, how does an employer with a self-funded plan manage this?


With the anticipated growth of healthcare costs and the high costs paid to hospitals by health plans, it becomes a real challenge to “bend” healthcare costs downward.


How leveraging coupons and copay cards can save some serious money.
By Peter Beerman, Senior Vice President, HealthSmartRx Solutions
 


A look at some of our successes over the past year along with some insights into 2019 by our CEO, Phil Christianson.


What happens if an employee's health plan doesn't have negotiated pricing with their hospital? Unless the patient and plan pay the full price amount for services, they could find themselves in litigation. As more small and mid-size companies opt to self-insure, finding a way to better control the cost of facility and hospital expenses has proven Reference Based Pricing (RBP) to be a smart solution.


For employers who self-fund their health plan, the first decision is choosing how to administer your health plan. When outsourcing your plan, you can use either a Third Party Administrator (TPA) like HealthSmart or an Administrative Services Only (ASO) program from an insurer (Carrier). In either case, they’ll help you design and build your plan and then manage the day-to-day. But that’s essentially where the similarities end.


Ready... Set... Self-fund!

9/21/2018 11:45:03 AM

It’s that time of year for employers to evaluate if their health program is running efficiently. This is among the most important decisions employers will make all year because of the financial and service impact to members. Here are just a few things to think about when weighing the options.


As employers look for ways to lower healthcare costs, more are looking Reference Based Pricing. But is that enough? Wait until you hear about SmartDecision! 


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