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Industry Updates

This broad category includes articles concerning health insurance costs, carrier and health plan news, changing benefits technology, and surveys by the Kaiser Family Foundation and others on employee benefits.

Health Care Is ‘Overwhelmingly Complex’ For Older Adults, Experts Say: ‘Ever-Increasing Hurdle’

Adults tend to need more medical care as they age, but coordinating that care can be stressful and strenuous for seniors. Getting in-person care and treatment can require “substantial time, effort and cost” for older adults and their partners or caregivers, according to a new study from Brigham and Women’s Hospital in Boston. Led by Ishani Ganguli, ...

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Biden Signs $1.2T Spending Package To Fund HHS, Other Healthcare Programs

The new tranche includes funding for HHS, the Department of Labor, and the Department of Education, among others. Doing so sustains several healthcare grant programs related to provider training, federally funded health centers and national programs targeting specific disease

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Major Health Bills Fail To Make Cut Amid Competing Priorities

Major bipartisan health bills, including changes to the pharmacy benefit manager (PBM) industry and hospital payment reforms, were excluded from the $1.2 trillion government funding bill after members failed to come to a last-minute agreement.

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Change Healthcare To Start Processing $14B Claims Backlog As It Restores Clearinghouse Platforms

In its latest update on the response to the cyberattack on Change Healthcare, UnitedHealth Group said on Friday that its largest clearinghouse, called Relay Exchange, will be back online by the end of the weekend and the company will begin processing $14 billion in medical claims. UnitedHealth Group also posted an estimated timeline for restoring its systems ...

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A Mom’s $97,000 Question: How Was Her Baby’s Air-Ambulance Ride Not Medically Necessary?

Sara England was putting together Ghostbusters costumes for Halloween when she noticed her baby wasn’t doing well. Her 3-month-old son, Amari Vaca, had undergone open-heart surgery two months before, so she called his cardiologist, who recommended getting him checked out. England assigned Amari’s grandparents to trick-or-treat duty with his three older siblings and headed to ...

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No Matter The Risks, More Employers Are Choosing Self-Funded Plans

Although employers choose the plans in order to negotiate lower health care prices, they generally lack market power to do so effectively, so they need to critically assess whether it will help their bottom line, says a new study.

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6 Bad Assumptions To Avoid In Benefit Planning

Here are some of the bad assumptions I have observed over the years that can destroy an employee benefit plan.

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Insulin Caps Lowered Costs But Didn’t Improve Access, Study Finds

State caps on insulin costs lowered privately insured patients’ out-of-pocket spending, but they didn’t appear to increase insulin use, according to a new Annals of Internal Medicine study. Why it matters: The research suggests increasingly popular insulin caps alone aren’t enough to improve insulin uptake among patients with diabetes in commercial insurance. At least half of states in recent years ...

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73% Of Workers Would Jump Ship For Better Family Benefits

Nearly three quarters of employees would leave their jobs for better family benefits.

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Employers, Employees Facing Complications, After Drug ‘Copay Accumulator’ Ruling

The HHS rule, which mandates that health insurers not count copay assistance toward out-of-pocket costs, was struck down last fall, however, it is backfiring on patients with chronic diseases that need expensive drugs.

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