The percentage of U.S. doctors in adult primary care has been declining for years and is now about 25% — a tipping point beyond which many Americans won’t be able to find a family doctor at all.
Already, more than 100 million Americans don’t have usual access to primary care, a number that has nearly doubled since 2014. One reason our coronavirus vaccination rates were low compared with those in countries such as China, France, and Japan could be because so many of us no longer regularly see a familiar doctor we trust.
Meg Bakewell, who has cancer and cancer-related heart disease, sometimes emails her primary care physician, oncologist, and cardiologist asking them for medical advice when she experiences urgent symptoms such as pain or shortness of breath.
But she was a little surprised when, for the first time, she got a bill — a $13 copay — for an emailed consultation she had with her primary care doctor at University of Michigan Health. The health system had begun charging in 2020 for “e-visits” through its MyChart portal. Even though her out-of-pocket cost on the $37 charge was small, now she’s worried about how much she’ll have to pay for future e-visits, which help her decide whether she needs to see one of her doctors in person. Her standard copay for an office visit is $25.
As a fourth-year ophthalmology resident at Emory University School of Medicine, Riley Lyons’ biggest responsibilities include triage: When a patient comes in with an eye-related complaint, Lyons must make an immediate assessment of its urgency.
He often finds patients have already turned to “Dr. Google.” Online, Lyons said, they are likely to find that “any number of terrible things could be going on based on the symptoms that they’re experiencing.”
So, when two of Lyons’ fellow ophthalmologists at Emory came to him and suggested evaluating the accuracy of the AI chatbot ChatGPT in diagnosing eye-related complaints, he jumped at the chance.
Are your clients’ benefits teams feeling a bit frazzled? They’re not alone.
With the International Foundation of Employee Benefit Plans estimating that three-fourths of U.S. organizations plan to conduct open enrollment in October or November, we all know that Q3 is crunch time in the world of employee benefits. But it’s not too late for them to make this year’s open enrollment their most successful ever.
While the annual hustle and bustle of benefits open enrollment may be predictable, each plan year presents fresh challenges. Often these emerge from changes within the organization. Perhaps your client is introducing a new health plan or recently acquired a new eligible population through a business transaction. Their benefits team or third-party administrator may have experienced a lot of turnover this year, sparking worry about critical tasks falling through the cracks. Or maybe they’re juggling competing HR priorities that are making it hard to give open enrollment the attention it demands.
Many employers have voiced criticisms of pharmacy benefit managers, or PBMs, questioning why prescription costs are getting higher with no relief in sight — and it looks like insurance carriers have the same question.
Blue Shield of California dropped CVS as their PBM in August in the hopes of cutting down prescription costs by $500 million a year. Through Blue Shield’s new initiative, “Pharmacy Care Reimagined,” the carrier will work with multiple organizations — including Amazon Pharmacy, Abarca, Mark Cuban Cost Plus Drug Company, Prime Therapeutics and CVS Caremark — to cover the administration, navigation and delivery of prescription drugs.
Sponsored by AGA
If you’ve ever found yourself scratching your head over how to seal the deal and close those Medicare plans, you’re not alone. In this fast-paced world of insurance, it’s crucial to master the art of deal closure. That’s where we come in – as a seasoned Field Marketing Organization (FMO) and National Marketing Organization (NMO), we’re here to spill the beans on some killer strategies that have worked wonders for many of our agents. So, grab a coffee, sit back, and let’s dive into the world of successful deal closure.
A third set of Medicare Part B prescription drugs will cost up to $618 less per average dose beginning Oct. 1, announced the Centers for Medicare & Medicaid Services (CMS).
The policy, which applies to 34 drugs until Dec. 31, is possible through the Medicare Prescription Drug Inflation Rebate Program in the Inflation Reduction Act (IRA). It works through reducing coinsurance for beneficiaries with Part B coverage and discouraging drug companies from increasing prices faster than inflation, according to a release.
Sponsored by Word&Brown
One of the most immediate changes was the prohibition of gag clauses in contracts between insurance plans, insurance issuers, and providers.
Gag clauses are contractual provisions that restrict plans or issuers from sharing provider-specific cost information or quality-of-care information with patients, other providers, or plan sponsors. They can also prevent plans or issuers from electronically sharing de-identified claims data and other encounter information with patients and providers.
The CAA’s gag clause prohibition was designed to ensure that patients have access to the information they need to make informed decisions about their care, especially regarding costs. The prohibition also allows the entirety of the CAA’s transparency changes to function.
Fueled by chronic health conditions, catastrophic health claims and rising prescription drug prices, health care costs will experience a sizable hike next year, employers say.
U.S. corporate employers project a median health care cost increase of 7 percent for 2024, according to new data from the International Foundation of Employee Benefit Plans (IFEBP), a nonpartisan group with more than 31,000 members. It’s the second year in a row that employers have projected a 7 percent hike.
The foundation’s survey of 171 employers, conducted in early August and released this week, is important information that indicates that inflation continues to have an impact, although the numbers are not too surprising, said Julie Stich, vice president of content at IFEBP.
Russ Williams contributes to articles on professional growth for readers of California Broker Magazine. He serves as a mentor-advisor and offers one-on-one professional consultations based on The Clarity Conversation, a 9-Session Self-Renewal Consultation focused on overcoming nagging personal-professional challenges to re-claim personal-professional clarity
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EXIT PLANNING FOR BUSINESS OWNERS
Sponsored by Strazzeri/Mancini
In January we introduced succession planning for small business owners and suggested ways that group benefit brokers can consider to learn more about business succession planning and to work with a team to bring resources to their business owner clients. We wanted to offer an open invitation for group health brokers to both access online information on succession planning and join monthly calls and in person Exit Planning Institute Chapter meetings.
California Broker suggests joining a free Local Exit Planning Institute (EPI) meeting or Southern California Institute meeting (SCI.) The link below leads to resources you can take action on now.
Learn from independent attorneys, CPAs, bankers, financial planners, investment advisers, insurance and real estate professionals, presenting training sessions every week.
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SAVE THE DATES
CAHIP Innovation Expo
Jan. 22, 2024,10:00 AM – 5:00 PM, Sheraton Universal, 333 Universal Hollywood Dr, Universal, CA 91608
Women’s Leadership Summit 2024
March 25 – 27, 2024, JW Marriott Resort & Spa, Las Vegas, NV
Early Registration – Sales end on 09/30/2023
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- Sept. 21 @ 1 – 1:30 p.m. ET, LIMRA The Workplace Benefits Report – Second Quarter Review, LIMRA and LOMA Members Only. Register
- January 22, 2024, 10:00 AM – 5:00 PM, CAHIP Innovation Expo
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