June 2018 Volume 20 Issue 6
Providing Current Information on

Health Insurance Industry Issues and Legislation

Drugmakers Block Generics and Raise Prices
Manufacturers of brand-name drugs are thwarting potential generic brand
competitors while at the same time increasing their prices by double-digit
percentages annually. Makers of high-priced prescription drugs are not providing
generic drug manufacturers the product samples they must have to develop lower
cost versions of the branded drugs. While stonewalling the generic companies, these
brand-name drug manufacturers have increased their per unit prices by almost 60%
over the last four years.
Payors Saving Hundreds of Thousand on Dialysis Treatments
Smart payors are saving hundreds of thousands dollars a year on dialysis treatments
for qualifying End Stage Renal Dialysis (ESRD) patients and some payors are saving
even more. After a sign-up period, Medicare becomes the secondary insurer for these
patients' dialysis treatments. Payors are then only required to pay the Medicare rate for
these treatments. While most payors reimburse providers a multiple of the Medicare
rate, they still save big. With HHC Group, they save even more. That's because we only
charge a low, flat rate per treatment instead of taking a percentage of the savings.
Can Value-Based Care Bend the Healthcare Cost Curve?
Value-based care, paying for achieving measurable quality outcomes, has the
potential to improve patient health while reducing costs. "Bundled payments", a
value-based arrangement, reimburse a set amount for a given course of care. That
amount is then shared by the participating providers. This model has proven it can
generate thousands in savings for knee, hip, and spine procedures, reducing costs
for both employers and employees.
Americans Paying More for Healthcare Again
Healthcare costs for a family of four in the U.S. will top $28K this year, with
employees, once again, shouldering more of the burden. The cost for a family of
four receiving coverage from an employer-sponsored health plan is increasing by
4.8% this year, more than twice the rate of inflation. The good news is that this is
the second lowest rise in the 19 years the Milliman Medical Index has been tracking
the rate of healthcare spending growth in the U.S. The bad news for employees is
that their spending for healthcare coverage is increasing 5.9% this year.
Three Star Preferred Provider Program Additions
Hutsell Chiropractic
Nappanee, IN 46550

Grupo Medico Costamed
Ft. Lauderdale, FL 33339

Mark Skaggs
Wichita Falls, TX 76108

Benjamin Broom
Homewood AL 35209

Spearfish Regional Hospital
Rapid City, SD 57709