Health Insurance Industry Issues and Legislation

Consolidation in the healthcare industry continues unabated. Hospital ownership is already highly concentrated in 75% of markets. Hospitals and Venture Capital firms are gobbling up independent physician practices. As extensive research shows, the result is almost always decreased patient choice, eroded quality, higher prices, and less innovation.

For many of the 40% of obese people in the U.S. the new GLP-1 weight loss drugs can mean lower body mass indexes, better health, and longer and happier lives. For employers, they can mean huge increases in their healthcare spend both short and long-term as people must receive the drugs to continue to reap the benefits. Payors are scrambling to control the surging costs while improving member health.

As hospital and other provider prices rise sharply it is more important than ever to have a champion, like H.H.C. Group, in your corner negotiating significant reductions your out-of-network and high dollar in-network claims. Every day our attorney negotiators are saving our clients big dollars by getting signed agreements from providers to accept the appropriate for the services they provide.

Employers and third-party administrators must recognize there are significant business risks associated with health plans that exclude gender-affirming care. Those seeking gender affirming care have filed against employers and administrators and prevailed at exceptional rates. Self-funded groups must prioritize strategies to avoid legal consequences, financial losses, and reputational setbacks.