Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Employer Sponsored Insurance ESI

Employers are Experimenting with Innovative Health Plan Designs

September 26, 2018 - Just under half of employers participating in a survey from the National Business Group on Health (NBGH) are actively experimenting with innovative health plan designs that aim to foster new approaches to care delivery. NBGH found that employers expect healthcare costs to rise by 6 percent in 2019 without any efforts to reduce costs. However, employers still expect costs to rise by 5...


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Consumers Struggle with Health Plan Finances, Healthcare Literacy

by Thomas Beaton

The majority of consumers with employer-sponsored health plans lack the necessary financial health literacy to optimally manage their health plan finances, according to a new report from Alegeus. As high-deductible health plans (HDHPs)...

Reference Pricing Models for Prescription Drugs May Contain Costs

by Thomas Beaton

Reference pricing models for prescription drugs may help to contain spending and reduce high costs for beneficiaries, says a new report from the Commonwealth Fund. Currently, most payers use tiered drug formularies to manage drug costs,...

Employers Could See High Financial Returns for Mental Healthcare

by Thomas Beaton

More comprehensive coverage for mental healthcare could bring a financial return of four dollars for every one dollar spent by employers, says a report from the National Alliance of Healthcare Purchaser Coalitions (NAHPC). One in five...

How Employers Can Design High-Quality Cancer Care Benefits

by Thomas Beaton

Designing meaningful and high-quality cancer care benefits is a challenge for employer-sponsored health plans.   Cancer, a costly and complex condition that takes many different forms, requires coordination across the entire...

Nearly 20% of Employees Have Inpatient Out-of-Network Claims

by Thomas Beaton

Approximately twenty percent of employees with insurance had at least one out-of-network claim for inpatient care, according to a Peterson-Kaiser Tracker analysis. Employees with out-of-network provider bills may experience increased...

About 90% of Large, Mid-Size Employers Offer Medical Benefits

by Thomas Beaton

Close to 90 percent of employees in large and mid-size private businesses are offered medical benefits, according to data released by the Bureau of Labor Statistics. Larger businesses tend to see higher participation in employer-sponsored...

Pros and Cons of Small Business Health Options Program Health Plans

by Thomas Beaton

Health plans offered through the Small Business Health Options Program (SHOP) exchanges allow payers to provide the nation’s smallest businesses with affordable plan options that offer critical health benefits. SHOP health plans...

High Dollar Claims Rise by 87% in Employer-Sponsored Stop-Loss Insurance

by Thomas Beaton

The number of employer-sponsored stop-loss insurance claims of $1 million or more grew by 87 percent from 2014 to 2017, according to a new analysis from Sun Life Financial. Over the four-year period, 634 employees with $1 million claims...

Health Plan Cost Sharing, Deductibles Outpace Members’ Wage Growth

by Thomas Beaton

Health plan cost sharing and deductible spending have outpaced employee wage growth in the last ten years, according to data released by the Peterson-Kaiser Health System Tracker. Employees’ total financial responsibility increased...

Partners HealthCare to Self-Insure 100K Employees

by Thomas Beaton

Partners HealthCare has announced it will self-insure 100,000 of its employees, transitioning coverage from BlueCross BlueShield of Massachusetts to its own Neighborhood Health Plan, according to The Boston Globe. “Neighborhood...

AHIP, BCBSA, AMA Join to Improve Public, Private Payer Ecosystem

by Thomas Beaton

The Partnership for America’s Health Care Future (PAHCF), a newly formed coalition, consisting of leading healthcare provider societies and payer organizations, has committed to strengthening the nation’s private and public...

Short-Term Wellness Interventions Improve Employee Well-Being

by Thomas Beaton

Short-term wellness interventions can improve employee well-being and may help employers reduce their overall costs while maintaining employee health and productivity, according to a new study published in the American Journal of Health...

Pros and Cons of High Cost Sharing for Employer Health Plans

by Thomas Beaton

Employer-sponsored health plans that include high cost sharing expectations can help control spending for plan sponsors, but could create longer-term health risks for employee beneficiaries.   Striking the right balance between...

86% of Employers Use Financial Incentives in Wellness Programs

by Thomas Beaton

Eighty-six percent of employers offer financial incentives in their wellness programs, according to a new survey from the National Business Group on Health (NBGH) and Fidelity Investments.  This represents an 11 percent increase since...

Supplemental Insurance is a Value-Add Opportunity for Employers

by Thomas Beaton

Employers may have a prime opportunity to add value to their health plan options by offering supplemental insurance, according to a recent AHIP survey. The survey found that 95 percent of employees are satisfied with supplemental plan...

64% of Employees Say Financial Incentives Boost Member Engagement

by Thomas Beaton

Sixty-four percent of employees that participated in a new survey said financial incentives helped connect them to necessary healthcare resources and equip them for improved member engagement. The Clear Insights Survey fielded by Wex...

Medicare Advantage, Premium Revenues Drive Q1 Payer Profits

by Thomas Beaton

Healthcare payers experienced strong first quarter profits in 2018 because of sharp growth in Medicare Advantage (MA) enrollment and premium revenues, according to newly released earnings statements. The reports confirm the stability and...

JP Morgan: Value-Based Care Will Guide Amazon, Berkshire Work

by Thomas Beaton

Amazon, JP Morgan, and Berkshire Hathaway will build their new company upon best practices in value-based care, including improving preventive care and managing member costs through data sharing, said JP Morgan Chase & Co. CEO Jamie...

Regional Differences Seen in High-Deductible Health Plan Volume

by Thomas Beaton

Regional differences in high-deductible health plan (HDHP) volume and other health plan offerings may help employers adjust insurance offerings in ways that are more valuable to their employees, according to a new report from...

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