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Time to Talk About Trend
There have been a number of market-changing dynamics over the last few years affecting healthcare with COVID unsurprisingly being the most notable. There was a steep decline in healthcare utilization in April [...]
My Recent Experience with Kaiser Health System
I moved from the east coast to the west coast seven years ago. My employer had several options to choose from for my healthcare benefits. In addition to options with national insurers, such [...]
Utilization Profiling for Care Management (and Profitability!)
Although there are many variables influencing healthcare costs, the most important are unit cost and utilization. Unit cost is subject to many constraints in relation to both healthcare and the broader economy. Much [...]
Pharmacy Provisions of the Inflation Reduction Act
Introduction I read the 725-page draft of the Deficit Reduction Act[1] so you don’t have to. Well, I skimmed 427 pages of it while focusing on the 164 pages which make significant [...]
New Provider Negotiation Dynamics
In a recent Inspire article, Are We In For Significant Healthcare Cost Increases?, David Axene explained why healthcare cost trends may soon accelerate. This article explores one of the drivers for that [...]
Mother May I? Interpreting ACA Pricing Allowances
“Mother-May-I” is a classic kids’ game that teaches little ones to honor their mother by having players request to take steps towards their mother but only taking steps if their mother allows [...]