| 2 min
Americans have long struggled with a dysfunctional healthcare industry and legacy insurance plans that cost too much and don’t deliver. Instead of focusing on what’s wrong with the status quo, a recent study asked employees to prioritize what future health plans should offer.
| April 18, 2024
| 2 min
A comprehensive JAMA study analyzing 32 years of data suggests that health premiums for employer-sponsored health benefits have been rising faster than wages. These costs are often passed on to employees, further reducing or stagnating wages and increasing income disparities by race, ethnicity, and wage level.
| April 5, 2024
| 3 min
There is looming fiduciary litigation risk for employers who continue to passively patronize the legacy insurance and PBM industry with its long, public history of predatory practices. Johnson and Johnson leaders who were individually-named fiduciaries in a recent class action lawsuit can attest to this.
| February 19, 2024
| < 1 min
The results from the Commonwealth Fund 2023 Health Care Affordability Survey are grim. American consumers continue to struggle with unsustainably high costs and inadequate coverage. Unsurprisingly, nearly 40% forgo or delay needed care and don’t fill prescriptions to avoid risking financial ruin.
| October 30, 2023
| < 1 min
When the HIPAA Privacy Rule was enacted in 1996, its intent was to protect personal medical records and health information. This goal has since been weaponized by legacy health insurance carriers who withhold data from fully-insured plan sponsors to obscure their justification for higher premiums.
| May 7, 2023
| < 1 min
Medicare patients cheered when the Inflation Reduction Act capped monthly insulin costs at $35. Then drug manufacturers controlling 90% of the market set this $35 cap for everyone by bypassing the PBM middlemen. To protect their black box of profits, insiders expect PBMs to raise employer premiums.
| April 28, 2023
| 2 min
Mary B. skipped appointments and delayed chemotherapy when her cancer returned. Steven L. reduces refills by taking his thyroid medication every other day instead of daily. Others cancel needed care because they can’t afford time off from work and the additional costs of childcare and transportation.
| March 21, 2023
| 2 min
The healthcare industry continues to feed its addiction to obscene profits instead of better, more affordable patient care. While Americans are bombarded with relentless direct-to-consumer advertising (DTCA) pushing dubious drugs to an unwary public, health plan sponsors can provide a much-needed antidote.
| February 8, 2023
| 3 min
Health Affairs has launched a timely analysis of physician, hospital, and other health care provider prices in private-sector markets and their impact on overall spending. We applaud this pursuit of definitive answers but until such truths are revealed, employers won’t have any cost relief any time soon.
| January 31, 2023
| < 1 min
From stagnant wages to crushing medical expenses, employee net income has plummeted, preventing American workers from saving adequately for retirement. Pending legislation seeks to alleviate this crisis while a growing number of employers are boosting retirement benefits by reducing health care costs.
| December 29, 2022
| 2 min
From targeting the Affordable Care Act to clamoring for COVID relief funds, annual federal healthcare lobbying expenditures have risen a staggering 70%. Nearly $714 million has been spent influencing legislation to favor the industry and maintain obscene profits. Who’s spending all this money?
| December 17, 2022
| 2 min
Multiple studies affirm that millions of Americans are underinsured or completely uninsured. These grim results include the 54% of the population covered by employer health plans. While outrageous healthcare and premium costs are part of the problem, it’s clear employers need to step up and do better.
| December 10, 2022
| < 1 min
In the ongoing battle for talent acquisition and retention, 2 in 3 employers plan to expand their employee benefits program in the next 12-18 months. Yet 8 in 10 say out-of-control health care costs impede their ability to stay competitive. Is it really possible to compete without overspending? Absolutely!
| November 30, 2022
| 2 min
According to the National Institutes of Health, telehealth services have been around since the 1920s using the limited technologies of their time. A century later, virtual care has become commonplace thanks to the global pandemic... and it is here to stay, especially for mental health services.
| September 27, 2022
| < 1 min
While patients grapple with runaway costs and the indignities of the U.S. healthcare system, the largest health insurance firms posted solid year-over-year earnings growth for the first half of 2022. In fact, experts don’t think they’ll struggle at all despite worrisome economic conditions.
| September 2, 2022
| 2 min
Consumers cheered when the Hospital Price Transparency rule took effect in January 2021, requiring that facilities publish their payer-specific negotiated rates for drugs and services. Despite the positive news, there remains a blatant lack of compliance that continues to keep patients in the dark.
| August 24, 2022
| 2 min
In a unanimous and bipartisan decision, the Federal Trade Commission (FTC) will investigate the secretive practices of six of the largest Pharmacy Benefit Managers (PBMs) in the country. Diverse stakeholders are hopeful this action will unravel years of corruption and reduce prescription drug prices.
| July 7, 2022
| < 1 min
A study published in JAMA Health Forum reveals that pre- and post-sale rebates from prescription drug manufacturers to commercial health plan sponsors are steadily increasing. Far from reducing out-of-pocket expenses for patients, this convoluted backroom strategy actually makes things worse.
| June 15, 2022
| < 1 min
Most would agree with the common adage that you get what you pay for, but that’s not the case when it comes to paying for healthcare in America. U.S. spending per capita is up to four times higher than other wealthy countries and yet shockingly, we have the absolute lowest life expectancy of them all.
| April 6, 2022
| 2 min
Medical debt is devastating the credit integrity of American consumers. The Consumer Financial Protection Bureau (CPFB) has taken steps to mitigate this doom loop and the three major credit reporting agencies are now taking action as well, no doubt in response to a greater focus on medical debt.
| March 30, 2022
| 2 min
A report from the Consumer Financial Protection Bureau (CFPB) estimates that consumer credit reports include $88 billion in medical debt as of June 2021. The cause is a “complicated and burdensome” medical billing system that creates hard-to-fix errors that increase patient debt and reflect poorly on credit scores.
| March 8, 2022
| < 1 min
The U.S. Department of Justice (DOJ) and Federal Trade Commission (FTC) have done almost nothing over the past decades to protect market competitiveness and consumer interests in healthcare. Employers continue to grapple with ever-rising plan costs as members bear the brunt of fewer healthcare options at a higher cost.
| March 2, 2022
| 2 min
In the early days of COVID, America’s nurses were rightly celebrated as heroes. Many nurses had hoped that such long overdue recognition might lead to needed reforms, but that optimism seems to have faded. In fact, nurses are leaving hospitals in droves. Some are even abandoning the profession.
| February 3, 2022
| 2 min
Many school systems rely on property taxes for most of their budget. When a school district in Chester County, Pennsylvania challenged the charitable results of three nonprofit hospitals owned by Tower Health, they exposed the unethical practices that allow many nonprofit hospitals to beat the system. The school district won.
| January 26, 2022
| < 1 min
2020 was a very good year for pharmaceutical manufacturers. According to an independent analysis by the Institute for Clinical and Economic Review (ICER), Americans spent an additional $1.67 billion on seven drugs whose price increases were not supported by new or improved clinical evidence. And this was after pharmaceutical rebates and other concessions!
| December 1, 2021
| 2 min
Payment disputes between insurers and providers are nothing new. Even with their secret, self-serving network contract arrangements, these relationships have been perpetually uneasy.
| November 2, 2021
Vitori Health has eliminated the excess costs and conflicts of interest in legacy health plans and upgraded what really matters – payment controls and the member experience.
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