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Feds Move to Rein In Prior Authorization, a System That Harms and Frustrates Patients By Lauren Sausser / KHN.org / MARCH 13, 2023 / / Read Article Few things about the American health care system infuriate patients and doctors more than prior authorization, a common tool whose use by insurers has exploded in recent years. Prior authorization, or pre-certification, was designed decades ago to prevent doctors from ordering expensive tests or procedures that are not indicated or needed, with the aim of delivering cost-effective care. Originally focused on the costliest types of care, such as cancer treatment, insurers now commonly require prior authorization for many mundane medical encounters, including basic imaging and prescription refills. In a 2021 survey conducted by the American Medical Association, 40% of physicians said they have staffers who work exclusively on prior authorization. So today, instead of providing a guardrail against useless, expensive treatment, pre-authorization prevents patients from getting the vital care they need, researchers and doctors say. In December, the federal government proposed several changes that would force health plans, including Medicaid, Medicare Advantage, and federal Affordable Care Act marketplace plans, to speed up prior authorization decisions and provide more information about the reasons for denials. Starting in 2026, it would require plans to respond to a standard prior authorization request within seven days, typically, instead of the current 14, and within 72 hours for urgent requests. The proposed rule was scheduled to be open for public comment through March 13. In benefits and healthcare, the cost of inaction is unaffordable Lester J. Morales / EBN / March 13, 2023 / / Read Article Most employers, and their advisers, are insane — at least according to Albert Einstein's definition, which is "doing the same thing over and over and expecting different results." Every year they approach their largest organizational expense after payroll, health benefits, in the same old fashion, with little to no data to support increased costs or help improve the future; no plan to actually lower future claims; and full reliance on their insurance carrier to help lower cost. What does an insurance carrier call the premium it has paid? Revenue. Do you wake up in the morning wanting to lower your revenue? Why, then, are people surprised we've had double-digit cost increases for the last several decades? Doing the same thing you've always done is easy, and it's easy to make excuses for not changing.
Better employer health benefits: It’s about time Michael Schroeder / President and Founder, Roundstone / CRAIN'S CLEVELAND BUSINESS / March 12, 2023 / / Read Article It is the best of times. It is the worst of times. The healthcare ecosystem continues to rake in record profits. Yet, despite all the spending on healthcare, the US has the lowest life expectancy and the highest rate of people with multiple chronic conditions, according to The Commonwealth Fund. For employers, the problem has reached a national crisis. Healthcare costs continue to rise to record levels, driven largely by inflation, misaligned incentives, and the ongoing impact of COVID. Worse, many experts say these costs will accelerate over the next several years. Employers must figure out how to pay for these increases while remaining competitive. They are understandably reluctant to shift more costs to their employees and risk greater dissatisfaction from the workforce. This struggle affects small and midsize employers more acutely. They lack the scale of larger enterprises with more purchasing power and thus more options. Larger companies can afford to make managing employee healthcare and costs – often a top three business expense – a long-term strategy. For the 30 million other smaller businesses in our communities, it’s a different story. They are often not even aware they have options other than being fully-insured with a 100 percent fixed-cost monthly premium, and the merry-go-round of spiking renewals every year. Why? The system doesn’t want them to know. The status quo is perfectly comfortable for many players in the market who participate in the employee benefits marketplace. The industry focus is on profitability, rather than the best interests of everyday Americans, i.e. improving population health and saving lives. Transamerica Bolsters Group Term Life Insurance Policies with Employee Assistance, Travel, and Identity Theft Services Transamerica / Mar 13, 2023 / PRNewswire / / Read Article Transamerica announced today the availability of Transamerica Employee ResourcesSM, a suite of new benefits that employers can offer to help their employees strengthen work-life balance and get through challenging times. These services offer valuable confidential resources for employees and their families during times of need. Transamerica Employee Resources consists of three value-added services: A choice of Employee Assistance Program (EAP) models. EAP Core provides the policyholder's survivors at time of claim with simple access to confidential services like evaluations, grief counseling, referrals, and follow-ups at no added cost to employers or employees. EAP Plus offers enhanced services to all employees, such as additional counseling sessions and human resources services, and is available for employer buy-up at no additional cost to employees. Emergency Travel Assistance provides immediate support and assistance in cases of emergency when traveling more than 100 miles from home for less than 90 consecutive days, either for business or leisure, domestically or internationally. Identity Theft Services help protect and restore personal financial information. "Work-life balance is especially challenging when life outside the workplace is more complicated than usual," said Phil Eckman, President of Transamerica Workplace Solutions. "Employers know that employees can find it difficult to navigate through hardships while trying to focus on work. Transamerica's group term life insurance now includes confidential and easily accessible programs with no cost to the employee that help employees feel supported and stay productive. Transamerica Employee Resources is just one more way Transamerica shows our commitment to helping our customers live their best lives." Transamerica's Group Term Life Insurance is an annually renewable employer-paid term life policy that offers guaranteed issue, renewability to age 100 without medical exams, no evidence of insurability, portability if a covered employee leaves or retires, and employee buy-up options above the employer-paid coverage.
Companies enhance benefits to help employees balance their work and caregiving demands MAR 9 2023 / Stephanie Dhue / CNBC / / Read Article KEY POINTS Companies across the U.S. are dealing with a shortage of workers and a shortage of child care. The U.S. could lose about $290 billion a year in GDP in 2030 and beyond if the number of paid caregivers doesn’t increase and employees leave the workforce for care duties, one estimate said. The U.S. Department of Commerce is encouraging the semiconductor industry to offer more affordable care options for workers as a way to increase women’s participation in the workforce. EFFECTIVE COMMUNICATION STRATEGIES – WITH STACY FRY In Rockstars Rocking Podcast by Eric Silverman / February 8, 2023 / / Listen This episode of the #RockstarsRocking podcast features rockstar Stacy Fry, Director of Communications at AIA, Alera Group, out of Central Pennsylvania. Episode Highlights: How she got into the benefits industry The importance of employee education in benefits Is there such a thing as ‘too much’ communication about benefits? New products and ideas that have helped over the last few years Her work with NABIP (National Association of Benefits and Insurance Professionals) The mentorship program with NABIP membership The Benefits Cooldown 2023 Trends - Part 1 of 2 / / Listen Join Eric Silverman and Ed Ligonde for their continued discussion about what trends, technologies, and other benefits related strategies will be big in 2023. The Benefits Cooldown 2023 Trends - Part 2 of 2 / / Listen Join Eric Silverman and Ed Ligonde for their continued discussion about what trends, technologies, and other benefits related strategies will be big in 2023. |
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| Tuesday, 03/07/23 - -
Can’t Give Employees Raises? Add Benefits Wednesday, 03/08/23 - Benefits of employee retention credit for employers Thursday, 03/09/23 - - POLICY BRIEFS / Flexible Benefits for a Flexible Workforce: Unleashing Portable Benefits Solutions for Independent Workers and the Gig Economy Friday, 03/10/23 - - More than 80% of local governments have opted out of Colorado’s new paid family, medical leave |
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