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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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You've Done a Dependent Audit. Now What?  

Tuesday, June 28, 2011 4:16:00 PM Categories: Prior Presentations
Dependent eligibility verification (DEV) has risen from obscurity to common practice in the last decade. With these audits now commonplace for group health plans, the question arises – Now what? To help answer this question we have surveyed ... read more
 

24 reasons Why Claim Payment Error Occurs 

Tuesday, May 31, 2011 2:20:00 PM Categories: Prior Presentations
Why can’t claim payment errors be prevented or stopped? Every group health payer has the goal of paying every claim correctly the first time. No payer meets that goal. Despite years of effort and automation, even the most... read more
 

How Does Your Plan Compare?  

Friday, April 29, 2011 4:14:00 PM Categories: Prior Presentations
Self-funded plans are not all the same. They vary widely across a number of dimensions. Is your plan “typical” or “unusual”? In this webinar we will review over a dozen dimensions of self-funded plan performance. Using actual experience... read more
 

How Medicare Can Help Employer Health Plans 

Thursday, March 31, 2011 4:10:00 PM Categories: Prior Presentations
“I’m from the government; I’m here to help” seems comical. The funny thing is that when it comes to monitoring health plan performance and provider payment, it can be true. Medicare is America’s dominant payer. Its importance will only... read more
 

Administrative Fee Inflation: Causes and Consequences 

Thursday, February 24, 2011 3:07:00 PM Categories: Prior Presentations
Why hasn't automation reduced health plan administrative costs? Health claim billing and payment processing is almost all automated. Yet health plan administrative fees have not been reduced - they have skyrocketed! Why is this?... read more
 

Planning for (Next Year) 

Thursday, January 27, 2011 1:36:00 PM Categories: Prior Presentations
Do the self-funded health plans you work with have a management plan for 2011 (that goes beyond waiting for crises, open enrollment and renewal)? Whether they do or not, this webinar can be of help. If there is a 2011 plan, this... read more
 

Provider Scorecard 

Thursday, November 18, 2010 1:07:00 PM Categories: Prior Presentations
Finding claim overpayments is easy. Collecting them is not. Claim audits routinely find 5% to 10% in overpayments. But collection efforts typically yield 1% to 3%. Why does this happen? What can be done to improve overpayment collection ... read more
 

Past-Payment Administration: The Missing Link in Health Plan Management and Control  

Tuesday, October 26, 2010 1:25:00 PM Categories: Prior Presentations
Automation has revolutionized health claims payment. More claims are paid faster by fewer people. Yet administrative costs and payment errors have not gone down and in many instances have actually increased. How can this be? This webinar... read more
 

Complete Enrollment: The Source of Cost Control  

Tuesday, September 28, 2010 2:32:00 PM Categories: Prior Presentations
The longer you work in health benefits the more you realize that all costs are enrollment driven. That’s right, all costs: premiums, claims, risk, fees, liability, compliance, etc. FACT: Health care cost control requires accurate,... read more
 

Restoring Competition to the Self-funded Market 

Monday, August 23, 2010 10:56:00 AM Categories: Prior Presentations
Nationwide, the self-funded, group health market has become dominated by high cost administrators who justify their high costs with assertions of larger “provider discounts.” Competition in this market relies on meaningless and misleading... read more
 
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