The rise in health insurance claims in 2020 due to Covid, and the need for digital solutions have led to an increase in the need for third-party benefits administrators. According to a report by Allied Market Research, the insurance third-party benefits administrator market generated $280.69 million in 2020 and is projected to reach $517.98 million by 2030.
To read a summary and access the full report, click here.
A survey conducted by GoodRX and the American Telemedicine Association during the pandemic revealed that both physicians and patients had better outcomes than expected. In fact, 64% of providers who used telehealth felt better about that option than before the pandemic. Even those providers who didn’t use telehealth had a favorable view of it. Of those who reported, a majority thought telehealthcare improved or remained the same as in-person, and 37% said it was equal to in-person care.
Patients also reported satisfaction with telehealth—almost 60% preferred to see providers over video and said their experience was no different than in-person. Patients noted that it was easier to schedule appointments with telehealth and they believed providers spent more time with them virtually than in-person. However, don’t throw the baby out with the bathwater. Most physicians and patients preferred a hybrid model of both telehealth and in-person visits with more options for both providers and health care consumers. Read more here.
The No Surprises Act that addresses surprise billing will officially take effect in January 2022. The issue of surprise billing has been a hot one as both health care consumers and politicians began to investigate how often insured patients are billed for services they had no idea were out of network. Studies showed that this happens in one out of five emergency room visits and from other out-of-network providers that patients did not choose (i.e. anesthesiologists). These surprise bills can cost patients thousands of dollars in unexpected fees.
The new federal protections will apply to emergency services, post-emergency stabilization services, and non-emergency services provided at in-network facilities. Overall, the law says that doctors and hospitals can’t bill patients more than the in-network cost-sharing amount for surprise bills. Health plans and providers will be required to notify consumers of their surprise bill protections, however, It’s up to the patient to recognize what is protected and apply to seek relief. The toll-free number for the “No Surprises Help Desk” will be 1-800-985-3059. Consumers can also reach out to their health plans to appeal bills. Read more details here.
Source: Kaiser Family Foundation
Reference-based pricing (RBP) is used to eliminate surprises from medical billing. RBP advisers work with medical facilities to provide a clear understanding of what employees will pay for medical services, including surgeries, imaging, and more. The RBP experts find medical facilities that have great patient outcomes at affordable prices. While this innovative approach is quite a change, it can also bring about significant savings. Employers who have implemented RBP have seen as much as 25-30% cost reduction in the first year alone, which can be passed on to members “in the form of reduced premiums and out-of-pocket expenses.” Read more here.