Health Insurance Industry Issues and Legislation

No surprise. A new Health Affairs report found that self-insured employers pay more for many procedures than fully insured employers. The largest premiums are for endoscopies (8%), colonoscopies (7%), lab tests (5%), and moderate severity emergency room visits (4%). The report suggests that there may be opportunities for self-insured plans to secure lower prices and for policymakers to act in circumstances where self-insured plans have limited leverage.

H.H.C Group is a highly effective tool smart self-funded payors will be using again in 2024 to help ensure they don't pay more for the services their plan enrollees receive. With its suite of cost containment services, utilizing published and proprietary databases to determine the appropriate amount to pay, and its decades of experience in convincing provider decision-makers, HHC's attorney case managers will again be saving our clients millions of dollars on both their in-network and out-of-network claims.

Aggressive private equity acquisitions of physician groups raise concerns about their impact on health costs and quality of care. Acting on these concerns, the Federal Trade Commission has sued U.S. Anesthesia Partners and its private equity firm partner, accusing them of monopolistic practices for purchasing anesthesiology practices in Texas. According to FTC chair Lina Khan, USAP "bought up the largest anesthesiology practices, then jacked up prices and entered into price-setting and market-allocation schemes."

Companies making health equity a part of their core strategy believe they both encourage better patient outcomes and improve their bottom lines, according to a recent Bain and Company brief. Three in four executives say health equity bolsters brand value. Half say it increases revenue, while a third say it can cut costs. The key to maximizing the impact of a health equity strategy is creating and executing a plan that lays out the business case, sets measurable goals, and targets specific inequities.