United Benefit Advisors Insight and Analysis Blog

Biting the Hand that Pays Them

Posted by: Ron E. Peck, Esq.    Aug 10, 2017 9:30:00 AM

I was recently asked to speak to a gathering of hospital-sponsored health plans and providers of health care services about our health care system, and trends I see developing which threaten it. I’d planned to talk about how the Patient Protection and Affordable Care Act (ACA or Obamacare) only targets one-third of the health care system – that being payers (insurance), while mostly ignoring the other two-thirds: providers and patients. Call it a scapegoat, or something else, but of the three players in health care, insurance is the villain. It’s easy, then, to say that what’s wrong with health care is what’s wrong with insurance, and vice versa. As such, fixing health care then becomes fixing health insurance. Rather than assign blame to all three – providers, patients, and payers – it’s politically expedient to point a finger solely at the least popular of the three: the payer. And so, health care reform became health insurance reform; but as I’ve said many times before, insurance isn’t health care – it’s a way to pay for health care. This idea that insurance is to blame for the overall cost of health care, that it can strong-arm providers into taking whatever they want to pay, and thus, the rising cost of insurance is based solely on greed and not at all on the actual cost of the care, is a lie. There is another attitude that it’s easier for insurance to raise premiums than push back on the cost of care, because pushing back on providers is tough, and – for the insured – not having insurance means certain death (and thus they will pay any premium). This holds a little more water; however, it wrongfully assumes that without insurance there is no health care. Yet, the truth is that health care would exist with or without insurance; we’d just need to find a different way to pay for it. People “need” insurance – not for its own sake – but to pay for health care, because health care itself is too expensive.

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Topics: group health care cost, single-payer system, health care plan design, benefits cost control

Self-Funding Dental: Leave No Stone Unturned

Posted by: Gary R. Goodhile, CLU    Mar 30, 2017 9:29:00 AM

With all of the focus that is put into managing and controlling health care costs today, it amazes me how many organizations still look past one of the most effective and least disruptive cost-saving strategies available to employers with 150 or more covered employees – self-funding your dental plan. There is a reason why dental insurers are not quick to suggest making a switch to a self-funded arrangement … it is called profit!

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Topics: self-funding, dental insurance, benefits cost control, health care cost containment

Employers and Employees Teeter on Healthcare Cost and Coverage Tightrope

Posted by: Elizabeth Kay    Nov 21, 2016 12:08:52 PM

Over the past few years, we have seen the cost of health care steadily increase – a trend supported by the latest data from the 2016 UBA Health Plan Survey. During the recession, employers implemented health plans with higher copays, higher deductibles, or offered multiple plans with a variety of deductibles and pushed the cost of the lower deductible plans onto employees in an attempt to keep their costs for offering coverage at the same rate or less.

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Topics: health care cost, benefits cost control, group medical benefits, consumer-driven health plan, UBA Health Plan Survey, Elizabeth Kay

See Which Employers Are Aggressively Increasing Rx Tiers for Cost Savings

Posted by: Bill Olson    Jul 21, 2016 10:30:00 AM

The Latest UBA Survey data shows employers are flocking to two strategies to control rising prescription drug costs: moving to blended copay/coinsurance models vs. copay only, and adding tiers to the prescription drug plans. Almost half (48.9%) of prescription drug plans utilize three tiers (generic, formulary brand, and non-formulary brand), 4.3% retain a two-tier plan, and 44.1% offer four tiers or more. The number of employers offering drug plans with four tiers or more increased 34% from 2014 to 2015. The fourth tier (and additional tiers) pays for biotech drugs, which are the most expensive. By segmenting these drugs into another category with significantly higher copays, employers are able to pass along a little more of the cost of these drugs to employees. Over the last two years, the number of plans with four or more tiers grew 58.1%, making this a rapidly growing strategy to control costs.

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Topics: UBA Health Plan Survey, prescription drug cost, prescription drug plans, benefits cost control, Rx