Welcome to Inspire from AHP!
We created the Inspire blog to have a positive impact on both the health care system and its clients.
Is Self-Funding the Right Choice?
Does going Self-Funded really save your money, or does it just sound good… No matter how big or small a company is, there are always questions about how to handle health insurance for its [...]
Is it Time for an ACO Check-up?
With school soon to start many parents are scheduling check-ups for their kids to be sure all is well. With CMS’ recently announced changes to the Medicare Shared Savings Program (MSSP) it may be [...]
So How Much Profit is Enough? Guidance for Pricing Health Benefits
One of the key assumptions in health product premium rate development is the profit margin (i.e., contribution to surplus, risk charge, etc.). How should this be determined? How much is enough? How much is [...]
Benchmarking Without Benchmarks
Introduction Benchmarks are very useful and a great tool for deciphering analytics. They offer a point of reference to which we can compare and identify cost and quality improvement opportunities. Most of the [...]
Perverse Incentives in ACA’s Risk Adjustment
Introduction There has been significant discussion in the past several weeks about ACA’s risk adjustors, the New Mexico court decision halting risk adjustment and CMS’ response to that. However, the perverse incentives embedded in [...]
Resource Based Pricing
Introduction Some of the confusion about the US health care system is directly tied to prices. How much does it cost? What will my insurer pay? What will I have to pay? Pricing transparency [...]