"Let’s start a conversation. We would welcome the opportunity to learn about your challenges and goals for your employee benefit plan. We are confident that our different thinking can lead to improved employee wellbeing, lower costs and greater employee appreciation – resulting in a better outcome for both you and your employees."
– Dan Dorsheimer
Founder & Principal,
AIA Benefits Resource Group

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News

11Aug, 2016

This surprising thing has become the biggest driver of health insurance costs for companies

Tina Reed covers health care. | Aug 10, 2016, 7:19am CDT | The Memphis Business Journal
Skyrocketing specialty drug costs — like those for new-generation hepatitis C drugs that cost upward of $84,000 per treatment— are the No. 1 driver of health care expenses among large employers, according to an annual National Business Group on Health survey released Tuesday.
While specialty drugs are used by less than 4 percent of the population, 31 percent of employers surveyed by the Washington-based group indicated they are the top concern for driving their health care costs.
“This is surprising because specialty drugs weren’t even considered among […]

10Aug, 2016

Big Companies Expect Moderate Increases In 2017 Employee Health Care Costs

By Jay Hancock | August 9, 2016 | KHN.org

Big employers expect health costs to continue rising by about 6 percent in 2017, a moderate increase compared with historical trends that nevertheless far outpaces growth in the economy, two new surveys show.

“These cost increases, while stable, are both unsustainable and unacceptable,” said Brian Marcotte, CEO of the National Business Group on Health, a coalition of very large employers that got responses from 133 companies.

Employers are changing tactics to address the trend, slowing the shift to worker cost sharing and instead offering video or telephone links to doctors, scrutinizing specialty-drug costs and steering patients […]

4Aug, 2016

Aetna is notifying some doctors about their drug-dispensing habits

By Lenny Bernstein | August 3 at 3:57 PM | The Washington Post

(Toby Talbot/AP)
Many experts say the prescription painkiller epidemic started when physicians began over-prescribing powerful opioid medications, a well-meaning attempt to more aggressively treat patients’ pain. With addiction to those pills at crisis levels, they argue, a good part of the solution would be for doctors to rein in use of the drugs.

The giant health insurer Aetna is now actively encouraging change. Using the vast amount of data it collects from insurance claims by pharmacies, it has begun contacting doctors whose prescribing habits are far outside the norm.

“You […]

2Aug, 2016

Opioid-related insurance claims rose more than 3,000 percent 2007 to 2014

Dan Mangan | CNBC.com

Health insurance claims for people hooked on prescription painkillers and heroin skyrocketed as the number of Americans who fatally overdosed on those opioids hit record highs, a new analysis reveals.

The number of private health insurance claims related to opioid dependence diagnosis soared by 3,204 percent from 2007 to 2014, the analysis found.

The same analysis by Fair Health also found other disturbingly sharp spikes upward in the number of private insurance claims related to opioid abuse, drug dependence by pregnant women and heroin overdoses since 2011.

“The United States is in the midst of an epidemic of opioid dependence, abuse […]

2Aug, 2016

Large employers stick with employee health plans, small businesses another story

Aug 01, 2016 | By Dan Cook | benefitspro.com

A new survey from the Employee Benefits Research Institute outlines what employers are doing when it comes to health benefits packages for their employees. (Photo: iStock)

Large employers continue to believe in the value of sponsored health benefits for employees, despite the options available to them under the Affordable Care Act. But small employers are increasingly choosing to pull out of the health benefits business.

That’s what a survey from the Employee Benefits Research Institute (EBRI) found when it examined the percentage of employers offering health insurance from 2008 to 2015. Using data from the Medical […]

29Jul, 2016

Curbing chronic disease and paying for outcomes and value

By Reed Smith, July 25 2016 | benefitspro.com

In my last article, I talked about how the unsustainability in health care inflation must be addressed with transformational thinking.  What we truly need is revolutionary thinking.  A revolution in the health care industry is the only way to bend the trend, improve health and create a competitive advantage for employers who embrace it.  To accomplish this goal, these four challenges must be turned into strengths:

Curbing chronic disease
Paying for outcomes and value
Leveraging mobile health technology
Activating the consumer

In this post, I am focusing on curbing chronic disease and paying for outcomes and value.  Check […]

28Jul, 2016

Pa. health insurers defend requests for higher premiums

By Lenay Ruhl, July 27, 2016 at 2:30 PM | CPBJ

(Photo / Thinkstock)

In a hearing convened by state regulators, health insurers in Pennsylvania defended their requests to raise insurance costs in 2017 to make up for losses on plans offered under the Affordable Care Act.

Insurance companies say they are losing money on individual health plan options they sell through the ACA’s insurance marketplace, known as the exchange.

But the Pennsylvania Insurance Department worried that people won’t be able to afford these safety-net health plans next year if insurers get their way.

At the department’s hearing today in Harrisburg, insurers from across the […]

27Jul, 2016

What will happen with healthcare policy under President Trump or Clinton?

By Harris Meyer  | July 23, 2016 | Modern Healthcare.com

The November elections surely won’t end the nonstop, eight-year political war over the shape of the U.S. healthcare system. But the ballot results likely will determine whether the changes driven by the Affordable Care Act continue in the same direction or the system returns to its less-regulated, pre-ACA contours.

Heading into this week’s Democratic National Convention, Hillary Clinton has promised to preserve and expand the ACA’s coverage expansions and delivery system reforms. Donald Trump, who accepted the Republican nomination last week, says he wants to repeal them, without offering much detail about what […]

27Jul, 2016

Attorneys spar over Hershey-Pinnacle merger

July 26, 2016 at 3:59 PM | CPBJ

A federal court in Philadelphia today heard arguments about a merger between two of Central Pennsylvania’s largest health systems, with a decision expected later this summer.

The hearing in the U.S. Third Circuit Court of Appeals in Philadelphia brought together lawyers representing the government and the two systems, Penn State Health Milton S. Hershey Medical Center and Pinnacle Health System.

The merger had been approved by lower courts, but the Federal Trade Commission and Pennsylvania Attorney General continue to oppose it.

The latest round of arguments was heard by a three-judge panel led by former Pennsylvania […]

25Jul, 2016

When Health Insurers Merge Consumers Often Lose

By THE EDITORIAL BOARD JULY 25, 2016 | The New York Times
A wave of mergers in many sectors of the economy over the last several decades has significantly reduced competition and hurt consumers. That’s why the lawsuits filed last week by the Department of Justice and state attorneys general in federal court challenging two big heath insurance mergers were so important.

Antitrust officials say Aetna’s $37 billion acquisition of Humana and Anthem’s $54 billion purchase of Cigna will reduce the number of large national health insurers to three, from five today. That would lead to fewer choices and higher premiums for […]