Study Says Concerns About Orphan Drug Spending Are Unjustified

 | September 7

Rising concerns about spending on prescription drugs that treat rare diseases are not justified, according to a new analysis in the journal Health Affairs.

“We wanted to focus on the true impact of orphan drugs,” said Victoria Divino, a senior consultant at IMS Health and an author of the study. Researchers at IMS Health and drug maker Celgene analyzed U.S. pharmaceutical spending from 2007 to 2013 on more than 300 drugs that had orphan approval under the 1983 Orphan Drug Act. more

REPORT: It Now Costs Over $8,600/ Covered Employee

The Society for Human Resource Management has released their Health Care Benchmarking Report and there are some pretty compelling insights.

  • The average cost of employee healthcare makes up 7.6% of a company’s annual operating budget.
  • The average cost per covered employee has increased by nearly $500 in the span of one year
  • Employers spent an average of $8,669 per covered employee in 2015, compared to $8,171 per employee in the previous fiscal year.“
  • Almost all employers (98%) now offer healthcare coverage for full-time employees.
  • Fewer organizations offer spousal coverage and more organizations have a spousal surcharge than in previous years, to help curb costs. As such, 92% of employers offer coverage for the spouses of employees, down from 96% in 2011.


Smaller Companies Move to Self-Funding

Many expected that the federal health law would push these employers in this direction. An analysis by the Employee Benefit Research Institute finds evidence that these predictions are coming to fruition.

Instead of buying a health insurance policy to cover their workers, a growing number of small and mid-sized companies are opting to pay their employees’ medical claims directly, a potentially riskier practice financially called self-insuring, a recent study found. more

Large Employers Expecting Moderate Care Cost Increase

Two surveys suggest these companies continue to try new ways to control the expense of employees’ coverage.

Big employers expect health costs to continue rising by about 6 percent in 2017, a moderate increase compared with historical trends that nevertheless far outpaces growth in the economy, two new surveys show. Employers are changing tactics to address the trend, slowing the shift to worker cost sharing and instead offering video or telephone links to doctors, scrutinizing specialty-drug costs and steering patients to hospitals with records of lower costs and better results. more

Plan sponsors being sued, Personally.

by Ryan Jerico
Senior Consultant, TFG Partners

Truthfully, this is not an “I told you so” situation, but…. look at Dave Chase’s piece in Forbes and well….

For many years TFG Partners has been providing clients with in-depth audits via our 100% methodology. These medical plan claims audits routinely uncover issues of Other Party Liability, Duplicates and Coding issues and Plan Benefit compliance.. While there can be significant savings from correcting these administrative weaknesses, uncovering issues surrounding provider contracts, administrator policies that conflict with the plans’s benefits documents and intent, and shifting numbers in calculations to meet discount/performance guarantees has always been particularly troubling to us as auditors. Most of the time, our clients have shared our concerns and moved forward to have these issues corrected and recover dollars to the plan. We have also seen plan sponsors fail to act on the information presented.


Young bucks to pay more bucks to stay healthy


January 16, 2013

Are you on the younger side of the age equation—under 30? Then, as a young buck get ready to pay more for your health care, thanks to Obamacare.

According to a new study conducted by members of the American Academy of Actuaries, adults under the age of 30 will find their insurance premiums rise by more than 40 percent under health care reform. Happy New Year, youngsters!

How do these folks then save money on health care? The premiums for coverage are only one aspect of paying for health care. You can find ways to source cheaper insurance, such as working with brokers and agents, searching online insurance tools and websites, and talking to friends about their coverage. Paying for your benefits is definitely going to cost more if you are under 30, but the cost of care is also going up, and you need to find ways to control those expenses as well.

via BenefitsPro (Read the Rest of the Article)