Health Insurance Industry Issues and Legislation

Two Christian-owned businesses and 6 individuals have brought a lawsuit challenging the legality of the preventive care provision of the Affordable Care Act. The provision requires most private insurance plans to cover specific preventive care services/supplies and cancer screenings at no cost. If the plaintiffs prevail insurers and employers would again have control over whether to cover these services. The impact on premiums rates and patient costs could be substantial.

Nearly 9 in 10 respondents to a new survey of US employers took measures to address worker mental health needs this year. Two-thirds plan to make mental health and emotional wellbeing programs and solutions one of their top health priorities in the next 3 years. The vast majority already offer telehealth and on-site or virtual resources. Many are planning to implement a variety of additional strategies to support the emotional wellbeing of their employees in the coming years.

Private equity (PE) firms have invested almost $1 trillion in nearly 8000 health care transactions in the last decade, spending $26 million into 1,400+ healthcare acquisitions in 2001 alone. Questions are being raised regarding the compatibility of health care related costs and quality with PE's mission of maximizing revenues and profits. Evidence is mounting that PE's increased reach and dominance in some markets has resulted many times in higher prices and a diminished quality of care. Since 2014, companies owned or managed by PE firms have paid at least $500 million to settle lawsuits settled under the federal False Claims Act.

Whether it's mental health claims or those from all type of providers now owned by private equity firms, HHC Group's Case Managers are using their experience, expertise, and knowledge to identify provider decision makers and convince them to accept an appropriate amount for the services they provided. HHC's professional approach enables us to maximize our clients' savings short and long term. Now HHC is making it easier than ever for payors to learn how much more we can save them on their NSA, other out-of-network, and high-dollar in-network claims.