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How to Respond to the UC Health & Anthem Contract Dispute

September 25, 2023

In what is a regular occurrence between health systems and insurance carriers, Anthem, Inc. and UC Health, including UCLA Health, have yet to reach a contract agreement for 2024. As things stand today, Anthem members would lose UC Health Systems as in-network providers effective January 1, 2024, including health systems such as: UC Los Angeles UC San Diego …

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The US Healthcare System

September 18, 2023

The United States spends significantly more on healthcare per person than any other country in the world, according to data from the World Economic Forum:   Healthcare Costs in 2021 (Per Person): – United States: $12,318 – Germany: $7,383 (40% lower than the U.S.) – France, Canada, the United Kingdom, Australia, and Japan (average): Approximately …

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Update on the PBM Market

August 21, 2023

Last week, Blue Shield of California announced the end of a 15-year partnership with CVS Health’s pharmacy benefits manager Caremark, in favor of new partnerships to provide access to affordable prescription drugs. For now, Blue Shield is betting on a predicted $500M in annual savings by switching to Mark Cuban Cost Plus Drugs Company (MCCPDC) …

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Health Insurance and Benefits Strategies for Investors, Entrepreneurs, and Private Equity Firms

August 15, 2023

Health insurance and benefits are often an untapped source of value creation for entrepreneurs, private equity professionals, and investors. Entrepreneurs and private equity companies are in the business of creating value. This generally means they manage their companies in a way to increase revenue, decrease costs, and generally increase their value. Since a business increases …

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The Value of Offering Virtual Mental and Behavioral Health to Employees

July 18, 2023

In offering benefits such as a health insurance plan, an employer is looking to build trust and differentiate itself in the market for labor. Quality health coverage is important to employees since it impacts the health of themselves and their families. And strong benefits differentiate your job offer in the marketplace so prospective employees see …

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The Trending Weight Loss Drugs

July 11, 2023

It seems like in every circle people are discussing the new weight loss drugs. At the Academy Awards Jimmy Kimmel cracked a joke during his opening monologue. “Everybody looks so great,” Kimmel said. “When I look around this room, I can’t help but wonder ‘Is Ozempic right for me?’” So, what are these popular & …

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How to Improve Your Employee’s Mental and Behavioral Health

May 16, 2023

Interested in a free webinar with practical tips and strategies to support your employees’ mental health? Join John and representatives from Health Action Alliance / Mental Health Action Day and the American Foundation for Suicide Prevention next Tuesday for a jam-packed session on mental health and the workplace!

The Official End of the Pandemic Health Emergency (PHE)

May 9, 2023

The impact of the end of PHE will be immediate and underestimated; unfortunately, it is looking like it will destabilize the already broken health industry.  See below two things to make note of!   Cost Shifting to Private Insurers: It is true that the official end of the Pandemic Health Emergency (PHE) will likely result …

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What is a Self-Funded Voluntary Benefit Plan?

May 2, 2023

You are probably familiar with voluntary benefits – if you’ve watched a sports game or turned on the TV recently, you’ve probably seen an ad from Aflac, Allstate, and others. But you may not be familiar with how these plans are financed exactly. And if you’re a real finance and insurance nerd who is familiar …

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The Rise of Healthcare Costs & How to Reduce it

January 17, 2023

The Why According to the Centers for Medicare & Medicaid Services, in 2021, healthcare costs skyrocketed to $4.3 trillion. This is caused by the premium increases, higher deductibles and copays, and soaring prescription drug prices. Most of these costs are market driven from the unregulated prescription drug costs and healthcare providers’ salaries rank higher than …

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