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Narrow Networks

Narrow Networks

As outlined in my book, Not Rocket Surgery, An Employers Guide to Controlling the Health Care Supply Chain, one of the most important roles of an employer sponsor of a Total Control Health Plan is messaging to employees.  The fact is that the cost of health insurance...

The Value of the Network – Part 2

The Value of the Network – Part 2

In follow up to part 1 of our answer to the question, To Network or not to Network, we will be diving into the second primary selling feature of networks in addition to access, which is the discount. Anyone who has ever been involved in the process of shopping for an...

The Value of the Network – Part 1

The Value of the Network – Part 1

To Network, or Not To Network? That is The Question. Q: What do you get when you strip away the network from a health insurance carrier? A: An expensive claims administrator While certainly there are additional roles that insurance carriers fill, ultimately their...

One Hip Replacement is Equal to 97 New Cars

One Hip Replacement is Equal to 97 New Cars

Given enough information, most individuals tend to make the “right” decision.  In the case of health insurance, all things being equal, the “right” decision is to go to the highest quality and lowest cost providers.  The problem with health insurance is that rarely do...

Stepping Over Dollars to Pick Up Dimes

Stepping Over Dollars to Pick Up Dimes

Generally speaking, the “fixed costs” (administration, stop-loss/pooling, network access) represent 20% of health plan costs with claims representing the other 80%.  As a result, it would be logical for those concerned about cost reduction to focus on the 80%,...

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