Healthy Blood Pressure Starts at Home
Hypertension's link to heart disease and stroke is well documented. But it's lesser known that high blood pressure can lead to kidney disease, vision loss, and peripheral artery disease (narrowed arteries in the legs, arms, stomach and head). Controlling hypertension...
Top Stop-Loss Claims Reinforce Need for Proactive Wellness Approach
Cancer and heart disease account for 37% of total stop-loss claim reimbursements over the past four years. This demonstrates once again the importance of a wellness program to catch chronic conditions, and reduce the risk of high-cost claims, at their earliest stages....
MedBen Rx Client Saves 39% by Tackling Specialty Drugs
With specialty drugs now making up about half of total drug spending – and poised to go even higher as more new specialty drugs roll out every year – the need for workable access solutions grows. Fortunately, MedBen Rx has them. Our unique approach incorporates a...
Claim Algorithms: Good or Bad?
In claims progressing, algorithms – mathematical formulas used to scrutinize particular elements of a claim form – can be good when used to ensure the accuracy and consistency of claim payments... but bad when used as a tool to deny claims. In a class action lawsuit,...
The Importance of Building a Dentist-Patient Relationship
Just as establishing and maintaining a relationship with a family doctor is important to better personal wellness, so too is visiting the same dentist for regular checkups. HealthTechZone highlights the benefits of having a family dentist, including: Consistent And...
Helping You Meet Your Data Duties
MedCity News reports on the latest in a series of lawsuits by large self-funded employers against national carrier administrators. These cases place a spotlight on health plan administrators that do not provide employers access to their medical claims data, in...
Mental Health Parity Compliance: Too Much is Not Enough!
On July 10, 2023, the United States Office of Management and Budget (OMB) received the Department of Labor’s newly proposed Mental Health Parity regulations. This latest installment in health plan Mental Health Parity compliance is expected to be released in the near...
Popular Weight Loss Drugs Among Medicare Top 10 Sellers
A Kaiser Family Foundation (KFF) analysis of the 10 top-selling prescription drugs under Medicare Part D offers an interesting snapshot of pharmacy spend. The drugs in question comprised less than 1% of all covered drugs in 2021, but made up approximately 22% of total...
Survey: Half of Cancers Detected through Wellness Exams and Screenings
A new Aflac Wellness Matters survey found that about 1 in 4 employed adults in the U.S. skip regular checkups because they feel healthy, don't have the time, or don't like going to the doctor (among other reasons cited). Also, nearly half of adults said they have...
Summer’s an Ideal Time to Check FSA Funds
Hard though it may be to believe, we're more than halfway through 2023. For flexible spending account (FSA) users, it's an opportune time to check balances and stock up on summer supplies that can be purchased with FSA funds. FSA Store offers a variety of...
Beating National Cost Trends with Proven Saving Solutions
Medical costs are expected to increase 7% in 2024, according to a new report from PricewaterhouseCoopers (PwC). This would match the largest single-year increase since the beginning of the pandemic. “The higher medical cost trend in 2024 reflects health plans’...
Transparency, Value Commitment Counter PBM Concerns
A new playbook from the National Alliance of Healthcare Purchaser Coalitions lists the top 10 concerns employer health plans have with pharmacy benefit managers (PBMs): Promoting drugs with higher prices when lower-price options are availableOffering preferred...