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

Tim Ebel’s visit with an ear, nose and throat specialist at an Ohio clinic last October came to $348. At the same time, he got a second bill for $645. The hospital system that owns the Avon, Ohio, clinic had charged him separately for use of the office where he met his physician. It is ...

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 ...

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

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.

More than 100 provider organizations want the Centers for Medicare & Medicaid Services (CMS) to take a tougher stance on Medicare Advantage (MA) plans’ practices following an industry survey estimating billions per year are spent fighting claims denials. Providers spent nearly $20 billion in 2022 pursuing delays and denials across all payer types, yet those ...