August 2019 Volume 21 Issue 8
Providing Current Information on

Health Insurance Industry Issues and Legislation

Steel Company Saves $5 Million with RBP
In 2014 Pacific Steel and Recycling's healthcare costs were skyrocketing upward.
Their hospital charges had increased by 400%. In an effort to gain control, Pacific
switched to a Reference Based Pricing health plan. It worked. Pacific's health
spend dropped from $8 million to $3.5 million a year. In 2018 they refined their
plan by varying the Medicare multiple by type and place of service and are now
instituting other additional saving measures.
Choosing a Reference-Based Pricing Company
More and more payers, like Pacific Steel and Recycling, are moving away from
carriers and independent PPOs to self-funding and Reference-Based Pricing
(RBP) to gain control of their health spend. The question is which RBP company
to choose. Factors to consider include the RBP company's ability to assist in
designing the right RBP plan for you and in writing or helping to write a clear and
comprehensive plan. Equally important is how the company handles provider
appeals and how extensive and member friendly their patient advocacy is.
CVS Moves into Kidney Care
CVS announced that it is conducting a clinical trial of its HemoCare Hemodialysis
System for administering home hemodialysis. Home hemodialysis is part of CVS's
major initiative to improve patient health and decrease the costs associated with
kidney disease. Home hemodialysis helps facilitate longer, more frequent treatments
versus in-center treatments which more and more scientific literature indicates that
clinical outcomes for hemodialysis patients can be improved by longer duration
Avoiding Costly Employee Mistakes
Bad employee benefit choices can be costly for the employee and employer alike.
Employees waste an average of $750 a year by choosing the wrong plan. That wrong
choice can cost an employer anywhere from $500 to $2,100 year. Poor health care
spending decisions, especially by those with high-deductible plans, can also increase
both the employee and employer's health spend. These costly errors can be avoided.
Three Star Preferred Provider Program Additions
Lighthouse Pediatrics
St. Augustine, FL 32086

Christopher Dinning, DC
Mt. Carroll, IL 61053

Ophthalmic Associates
Johnstown, PA 15907

B&B Shelle Opt6ical
Chicago, Heights, IL 60411

Manalapan SDSC
Manalapan, NJ 07726

Donna Kligallon LCPC
Chicago Ridge, IL 60415

Tempus Labs Inc.
Chicago, IL 60654

Dur Equip Services, LLC
Spring, TX 77393

Acosta Neurology Consulting LLC
Maitland, FL 32751

Brad I. Peterson, LMHC
Vancouver, WA 98684

Friends Behavioral Health
Philadelphia, PA 19124