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This room contains pieces drawn from my experiences at Health Decisions. It offers practical advice for anyone involved in managing group health plan expenses.
From the present, this room contains articles and reports by others that I wanted to share. Reasons for sharing will vary, so expect a potpourri.
This room provides reference points and norms I have observed or documented that can be used by persons trying to get their bearings in the often confusing world of group health.
This room contains my views on the future of the US health care system. My intent is not to convince anyone, but to broaden the discussion beyond the political debate that passes for health reform in America.
This room contains recordings and trasncripts of conversations I've had with interesting people I have had the privilege of meeting. Some are friends, some professional acquantances; all have interesting perspectives worth sharing.
From the past, this room contains some of the talks and articles I have done that I thought were worth sharing.

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Reference-based pricing is gaining momentum — here’s why - Employee Benefit Adviser article 

Thursday, July 26, 2018 11:54:00 AM Categories: News and Views
This article makes a good case for billing and payment reform. Reference-based pricing using Medicare is a vast improvement over meaningless PPO “discounts” that currently dominate the self-funded market. Providers have completely co-opted PPO... read more
 

Why Your Health Insurer Doesn’t Care About Your Big Bills - ProPublica Article 

Monday, June 25, 2018 10:08:00 AM Categories: News and Views
Check out Michael Frank’s personal experience with health care billing. The fact that he is very familiar with how the health care system works makes his comments even more powerful. This is not an unusual event. What is unusual is that someone... read more
 

Prudence says: Don’t forget your ongoing fiduciary tasks! 

Tuesday, May 22, 2018 10:22:00 AM Categories: Topics of Conversation
In this video, Prudence discusses the ongoing fiduciary responsibilities that need to be accounted for. The resources Prudence refers to are: https://www.irs.gov/pub/irs-pdf/p969.pdf;... read more
 

Reducing clients’ health spend by taking an axe to claims - Employee Benefit Adviser article 

Thursday, May 17, 2018 11:37:00 AM Categories: News and Views
We couldn’t have said it better. Audits are how you find and fight the waste, abuse, and fraud in every health plan. When is the last time you audited your plan claim and enrollment spend? It should be every year. If you haven’t audited in over... read more
 

What to know about the first reference-based pricing lawsuit - ebn article 

Monday, April 9, 2018 10:34:00 AM Categories: News and Views
We'll be keeping an eye on this case making its way through the legal system. It may help resolve one of the biggest impediments to payment reform: provider balance billing. read more
 

Prudence says: Happy New Year! 

Wednesday, December 27, 2017 3:17:00 PM Categories: Tools of the Trade
If you’re newer to Health Decisions, you may not yet have met Prudence. Prudence - the Prudent Person – is the star of a video series we launched last year to help educate plan fiduciaries and their advisors, brokers, and... read more
 

TPA Has Fiduciary Duty to Establish and Maintain Transparent Fee Arrangements - MyHealthGuide article 

Thursday, October 12, 2017 11:14:00 AM Categories: News and Views
This article in the latest MyHealthGuide Newsletter warns of hidden TPA fees. Hidden fees are more common and costly now than ever before. That growth is tied to PPO agreements that let payers and providers agree on how to spend plan money... read more
 

Prudence Says...Get READY to Control Your Plan Data! 

Tuesday, June 6, 2017 4:44:00 PM Categories: Tools of the Trade
In our last video, Prudence explained the basics of the fiduciary plan year, breaking it down into three phases: Ready, Aim, and Fire! This week, she's back to discuss months 1-4 of the year, or, the "READY" phase. This phase primarily involves... read more
 

Self-Insurance Bill Passes House Vote, Heads to Senate - MyHealthGuide Newsletter article 

Monday, April 10, 2017 10:26:00 AM Categories: News and Views
While not garnering the headlines of the “repeal-and-replace” debate, in his "MyHealthGuide” Newsletter Ernie Clevenger shares reporting on a significant development – bi-partisan Congressional action! The House passed a bill, (HR 1304) “The... read more
 

Prudence Says: Set Up Your Health Plan as a Separate Legal Entity! 

Tuesday, April 4, 2017 11:08:00 AM Categories: Tools of the Trade
Prudence is back with another video on self-funded health plans! This time, she's focusing on plans that are their own legal entity. It's something Prudence (and Health Decisions!) advises for your health plan. As a fiduciary or ABC team... read more
 
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