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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.

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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Surprise Medical Bill Law Has Been Good For Providers

The federal process for resolving billing disputes for out-of-network care has to date yielded payouts well above what Medicare and most in-network private insurers would pay providers, according to a new Brookings Institution analysis provided first to Axios. Why it matters: That could lead to downstream effects like higher premiums — quite the opposite of what Congress intended ...

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Key Health Care Takeaways From President Biden’s State Of The Union Speech

President Joe Biden made health care affordability a centerpiece of Thursday evening's address, announcing he is calling on Congress to expand the $2,000 out-of-pocket Medicare prescription cap to all private insurance.

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Despite Increased Focus By Employers, Workers Expect More Wellbeing Benefits

A troublesome 2 in 3 employees would change their jobs for better benefits, and 46% of workers are actively considering a job change in 2024.

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