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Shifting Models Could Advance Captives’ Role in Health Care

Rising health care costs, shifting care delivery models, escalating mergers and acquisitions activity and a potential new megaplayer are all complicating the health care landscape, but could also boost the use of captive insurers to cover health care risks, particularly group captives.... Stop-loss captives can be a valuable tool for employers navigating the evolving health READ MORE>

Reference-Based Pricing: 4 Steps to Successful Implementation

Is reference-based pricing the future of the health care industry? There are too many fluctuating variables currently in play to say for sure, but one thing is certain: it has a lot of appeal. “To me, being a financial guy, it made sense,” says Mark Gitter, chief financial officer for San Antonio-based GVTC Communications, which READ MORE>

8 Trends That Will Impact Worksite Wellness In 2018

The New Year will bring in some exciting corporate wellness trends for 2018.... If you’re wondering what’s next for the ever-evolving wellness industry, take a look below for some workplace wellness trends can you expect to see in 2018.... When corporate wellness programs first took off, the focus was primarily on smoking cessation or weight READ MORE>

Telemedicine on the Rise: Five Factors Driving Telehealth Growth in 2017 – and Beyond

Telehealth has been a growing point of emphasis in U.S. health care discourse, as health care providers look to leverage interconnectivity to treat patients from a distance and legislators seek new ways to improve care. In the past year, new state and federal regulations have cleared the way for telehealth programs to thrive in a READ MORE>

Survey: Self-Funded Health Plans Grow in Popularity

As organizations begin to assess options for group health coverage in 2018, new data out this week could help provide some perspective. Employer premiums on health care plans rose higher this year than they have in the past five years.... Additionally, self-funded plans...are also becoming more prevalent...[and] are becoming increasingly desirable to employers.... READ MORE

Thorough Claim Review Leads to At-Home Treatment Solution that Saves Nearly $100K Per Year for Individual Member

One thing that’s often a real difference maker for self-funded clients is the emphasis that’s placed on health claim review. As third party administrator (TPA) MedBen noted in a recent blog post, the savings opportunities identified can be quite substantial – even on an individual basis. The TPA shares a case study that shows how READ MORE>

The Rise of Reference-Based Pricing

Reference-based pricing (RBP) is a fast-growing alternative to the PPO systems self-funded employers have utilized for their group benefit plans over the past 30 years.... As the PPOs started to build larger networks and attempted to bring costs down, they met resistance from key providers.... there were no regulations on what hospitals could bill for READ MORE>

SPBA Releases Industry Update & 2018 Forecast for TPAs & Self-Funding

In preparing for the year ahead, the Society of Professional Benefit Administrators (SPBA) has released its State of the TPA Industry & Forecast for 2018. Fred Hunt, SPBA’s active past president, has been writing this report annually for the past 37 years.... As with years past, the 2018 Forecast shares a candid perspective on current READ MORE>

More Smaller Companies Are Self-Insuring Health Benefits

Small and midsized companies are increasingly providing their own health coverage for employees instead of buying fully insured plans .... As the Affordable Care Act drives up premiums because of more requirements and taxes, self-insurance has become a more attractive option because it is often less expensive than purchasing fully insured plans.... But some policy READ MORE>

Self-funding Health Plans is Hot, But Could Get Tougher to Do

Small employers are facing formidable hurdles as they consider self-funding health insurance plans. But self-funding still holds appeal.... Increasing regulation of self-funded health plans is complicating the efforts of some employers as they seek an alternative to plans offered under the Affordable Care Act, one analyst says. Most of the stiff regulation involves stop-loss, the READ MORE>