Healthcare Costs Projected to Grow 7% Next Year A study conducted by PwC showed that healthcare costs are expected to rise 7% next year due to inflation which is causing providers to seek rate increases from insurers and as pharmaceutical costs increase. As in other industries, labor shortages and high labor costs are driving providers […]

Pharmacy Benefit Managers (PBMs) Under Fire in Washington For years lawmakers have aimed criticism at pharmaceutical companies for the increasing costs of medications in the United States. However, the cost of prescriptions lies in the lap of three of the largest pharmacy benefit managers (PBMs), OptumRx, Caremark, and Express Scripts. These PBMs also happen to […]

Telehealth Remains Strong for Mental Health & Substance Abuse During the height of the pandemic, telehealth use exploded, going from 1% use to 13% for outpatient appointments from March-August of 2020. As more people began to go back in-person to the doctor, telehealth has waned. However, telehealth for mental health and substance abuse is still […]

Third-party Benefits Administrators (TPA) Market to Increase by $514.98 Billion 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 […]

Court Rules ERISA Plans Can’t Exclude Autism A California court ruled that a company with an ERISA plan covering autism, cannot limit coverage for the therapies that applied to that condition. The court determined that an employer who had an ERISA plan that covered autism but limited treatments was in breach of the Parity Act […]

Hospitals Caught Hiding Pricing Data in Search Results Hospital pricing transparency has been a hot topic since last fall. Last year the Trump administration set a rule in place to require consumer access to hospital pricing on health care system websites. The Wall Street Journal did an investigation into whether or not hospitals were complying […]

Medicare for All and Other News “Mostly False” Rating for Sanders Statement on Single-Payer Savings Senator Bernie Sanders recently cited a study from British medical journal, The Lancet, that stated a single-payer system would save the health care system “hundreds of billions of dollars”. However, the Kaiser Health News pegged this statement as “Mostly False” […]