Tag: Health plans

9 Ways to Reimagine Failing Health Plans

Here’s how it should work for someone covered by an employer-sponsored health plan: You work hard. You need health care. You visit the doctor, who identifies a current or potential issue and provides the care you need. A month later, you aren’t agonizing over whether you should pay the rent, send your kids to summer […]


HSA Use Grew 23% Between 2016 and 2017, Report Finds

The number of health savings accounts (HSAs) surpassed 21 million, holding about $42.7 billion in assets, according to a research report by Devenir. The investment advisor firm noted that represents a year-over-year increase between June 30, 2016 and June 30, 2017, of 23% for HSA assets and 16% for the accounts.

Attitude Shift: The Glacial Pace of Hospital Billing Transparency

Hospitals are still resisting transparency, and reacting in unconstructive ways to reference-based pricing. The evidence shows many health care providers have some way to go in embracing changes designed to repair our nation’s cost spiral. We in the self-funding industry can make a difference, and at the same time protect our plan members from unfair […]

Prohibited Restrictions and Rescission Clarified in Agency FAQs

Compliance with preventive health service requirements and other mandates of the health care reform law, along with disclosure obligations involving mental health parity requirements for health plans, were addressed in frequently asked questions issued by the U.S. Departments of Labor, Health and Human Services and Treasury on April 20. Affordable Care Act compliance issues covered […]

Impact on Life Duration & Quality Drives Drug Value

A prescription drug’s ability to prolong life is a top factor health plans are using when fixing benchmark prices for drug reimbursement, followed by the drug’s ability to improve the patient’s quality of life, health care stakeholders said at an April 15 briefing hosted by the Alliance for Health Reform. Steven Pearson, MD, MSc, president […]

How Health Plans Help Providers Convert to Quality & Value Models

Health care providers need help moving to value-based reimbursement and adopting accountable care models, and insurers and health plans often provide the best support, health plan executives told a recent conference. They discussed best practices for helping providers adopt value based pay and outcome-based reimbursement on April 11 at the World Health Care Congress in […]

Supreme Court Seeks New Accommodation in Birth Control Case

Religious non-profit employers that are not eligible for a church exemption seemed more likely to change the process of opting out of the Affordable Care Act requirement that health plans cover contraceptives and family planning services without cost-sharing. In a two-page order dated March 29, the U.S. Supreme Court told lawyers arguing Zubik v. Burwell, No. 14-1418 (cert. […]

Follow-up McCutchen ruling shrinks plan recovery

A federal district court in Pennsylvania denied a large part of US Airways’ attempted recovery from the estate of plan participant James McCutchen, citing inconsistencies between the company’s plan document and summary plan description. If a plan’s official plan document states that its language trumps that of the SPD, the plan should not assert rights […]

HHS Launches Phase 2 HIPAA Privacy Audits

The U.S. Department of Health and Human Services has officially launched its long-awaited Phase 2 HIPAA audit program, the head of HHS’ Office for Civil Rights said at a March 21 conference. The process has begun with the emailing of address verification letters to a pool of potential auditees, said OCR Director Jocelyn Samuels. OCR […]