Dec 22, 2023 | Acquisition Cost Index (ACI) pricing, Cost Plus Pricing, Cost Savings, Drug costs, MedBen Rx, Pharmacy, Prescription, Rx Costs, Savings, Spread Pricing
Spread pricing is the difference between what pharmacy benefit managers (PBMs) charge health plans for drugs and what the pharmacy actually pays for them. Often, this “spread” can be substantial, as PBMs profit greatly from their lack of transparency… so it’s not...
Nov 28, 2023 | Cancer, Cost Savings, Mental Health, Pharmacy, Prescription, Savings, Survey, Transparency
A recent survey of large employers by the Business Group on Health revealed considerations that self-funded plans expect to focus on in the coming year, including: Pharmacy costs. High-priced drugs and overall pharmacy costs are a source of concern for over 90% of...
Oct 17, 2023 | Cost Savings, Leveraged trend, Savings, Stop-Loss, Trend
Have you ever received a larger-than-expected stop-loss premium increase and your carrier blamed “leveraged trend”? Well, here’s what they mean. The fact that rising claim costs contribute to higher plan costs may be self-evident… but not just in ways that are...
Oct 16, 2023 | Cost Savings, MedBen Rx, Pharmacy, Prescription, Rx Costs, Savings
From a new report published by the U.S. Department of Health & Human Services: “Over the period from January 2022 to January 2023, more than 4,200 drug products had price increases, of which 46 percent were larger than the rate of inflation. The average drug...
Sep 19, 2023 | Alternative Reimbursement Strategies, Cost Savings, Direct-to-Employer Contracting, Fair Market Pricing, Reference-Based Pricing, Savings
By self-funding your health coverage, you will save money compared to a fully insured plan. But by going a step further with MedBen alternative reimbursement strategies – or even multiple steps further, as we’ll explain below – you stand to save even more. In...
Sep 5, 2023 | Alternative Reimbursement Strategies, Claims, Comparative Effectiveness, Cost Savings, Direct-to-Employer Contracting, Drug costs, Fair Market Pricing, Forensic claims review, High-cost claims, Inflation, MedBen Rx, MedBen WellLiving, Reference-Based Pricing, Rx Costs, Savings, Self-funding, Specialty Care, Survey, Wellness
A new survey by International Foundation of Employee Benefit Plans found employers expect plan costs to increase seven percent in 2024. As to why, they gave a range of answers, with the top four reasons representing 71 percent of responses (see chart below). As it...