CMS Announces 2025 Medicare Part D Final Rules Affecting Health Plan Credibility
On April 1, 2024, the Centers for Medicare & Medicaid Services (CMS) released the Announcement of Calendar Year (CY) 2025 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (the “Rate Announcement”). The Rate Announcement...
Primary Care and “Essential 8” Keys to Preventing Health Disease
Regular primary care visits are crucial to preventing chronic heart conditions, a new study of personal health habits suggests. Jeremy Sussman of the University of Michigan Department of Internal Medicine said, "As a society, we need to recognize that preventing...
Going “Beyond the Discount” Saves Client 56% on Claims Cost
Claim savings don’t have to end with the PPO network discount. With MedBen's forensic claims review services, savings are produced after network discounts are applied, but before claims are paid. As the case study below shows, while PPO network discounts alone will...
Looking for Total Transparency and Lower Costs in Pharmacy Benefits?
Employers are turning away from the "big three" pharmacy benefits managers to other PBMs that offer greater transparency and lower costs, says Wharton professor of health care management Lawton Robert Burns. As one of those alternatives, MedBen Rx is bringing...
Telehealth Visits Decline, But Remain Above Pre-Pandemic Levels
It should comes as no surprise that telehealth visits saw a big upswing in early 2020, as COVID-19 began to spread. As the pandemic subsided, telehealth visits slowly dropped but still retain residual popularity. The graph below shows bimonthly telehealth utilization...
Maximize FSA/HRA Effectiveness with Member Online Services
A flexible spending account (FSA) member can save up to 30% for every dollar they contribute. Likewise, health reimbursement arrangement (HRA) members can greatly lower out-of-pocket costs by using their employer-funded plan to pay for medical expenses. But...
Fighting Back Against Chronic Condition Costs… Physical AND Financial
The cost of five major chronic conditions, in physical and financial terms: Cardiovascular disease (CVD) is the leading cause of death in the United States, and cost the U.S. $407.3 billion between 2018 to 2019.Between 2017 and 2020, 10% of adults age 20 or...
More Gene Therapies Available, But Cost Remains a Concern
Back in late 2022, MedBen spotlighted the growth of gene therapy, a transformative medical approach that potentially cures genetic disorders by correcting or replacing an individual's DNA. As we noted, these therapies go beyond treatment to literally "solving the...
How Many of Your ER Visits Are Avoidable?
For MedBen clients in 2023, 16% of emergency room visits were potentially avoidable… typically for conditions that could have been better managed in a more cost-effective setting. A visit to an urgent care facility or family doctor cost, on average, $1,582 less than...
Reduce Your Vision Loss Risk through Regular Eye Exams
As we get older it's not unusual for our eyesight to get a little fuzzy... but a form of partial sight loss known as "low vision" is less common and can't be corrected by standard glasses or surgery. However, simple preventive actions can help reduce your risk for eye...
Comparative Effectiveness Maximizes Drug Savings by Maximizing Clinical Value
At January's Benefits Advisory Conference, MedBen President & CEO Kurt Harden observed that when the Food and Drug Administration (FDA) evaluates a new drug to be approved for sale, it has to be safe and effective, but not necessarily superior to what's already on...
Have You RSVPed for Your MBU Roundtable Yet?
Invitations to two upcoming MedBen University (MBU) events have been emailed... the Municipality & Public Employer Roundtable on Wednesday, April 3, or the Private Employer Roundtable on Thursday, April 11. If you haven't received an invite to your event yet,...