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  01:51:00 pm, by MedBen5   , 219 words,  
Categories: Announcements, Prescription, Hospitals, Cost savings, MedBen University

2015 Trend for MedBen Hospital Clients Less Than 3%

MedBen University

At the 14th Annual MedBen Hospital Roundtable on March 24, Vice President of Sales & Marketing Brian Fargus revealed that in 2015, total medical and pharmacy costs for the company's hospital block increased only 2.8% from 2014. This continues a five-year trend of small cost increases for MedBen's hospital clients.

"From 2011 to 2015, the cost trend was only 4.9%," Fargus said. "That's basically just 1% per year."

Hospitals are unique among the industries that MedBen serves in that they can help themselves keep health care spending down by steering plan members to their own facilities for medical care and prescription drugs. Through these and other cost containment strategies, MedBen's hospital clients have managed to keep average cost increases well below national trends.

In his presentation of pharmacy benchmarks, MedBen President & COO Kurt Harden noted that hospital clients are increasingly taking advantage of "own use" prescription dispensing to benefit their bottom line. "At several of our hospital groups, more than two-thirds of plan members' prescriptions are now filled in-house," Harden said.

MedBen will be conducting a Government Roundtable on Thursday, April 7 from 9:00 a.m. to 1:00 p.m. at the C. Arthur Morrow Conference Center in Newark, Ohio. The event is open to interested municipalities, even if they are not MedBen clients. If you would like more information, please contact MedBen Sales Analyst Sally Wood at (800) 423-3151, Ext. 502 or


  02:23:00 pm, by MedBen5   , 268 words,  
Categories: News, Health Care Reform

Compliance Date for SBC Changes Pushed Back


A recent U.S. Department of Labor notice gives employers until the first day of the first plan year that begins on or after April 1, 2017 to comply with upcoming regulatory changes to the Summary of Benefits and Coverage (SBC) which they must distribute to their employees.

Effective April 1, 2017, and for all plan years beginning thereafter, employers must revise their SBCs to meet the new requirements and format. If your plan year begins at the first of the year, you will have to begin using the new SBC format effective January 1, 2018. Remember, however, that the revised SBC must be distributed along with any open enrollment materials used prior to your plan year, which means that you will need to have the new SBCs ready at least 30 days in advance to allow for timely distribution.

Late last fall, the DOL reminded employers that SBCs must be given to employees in several different circumstances, not just at open enrollment. Employers must remember to hand out their SBCs to eligible new hires, when an employee has a special enrollment event and any time the plan makes a change that affect the content of the SBC.

The Affordable Care Act requires that group health plans provide a uniform summary of their benefits to eligible individuals to be used in comparing any different coverage options that are available to these individuals. MedBen prepares SBCs as a part of our administrative service to our clients.

MedBen clients with questions regarding their group's SBCs are welcome to contact Vice President of Compliance Caroline Fraker at

Read more about the Department of Labor notice at Business Insurance.


  03:13:00 pm, by MedBen5   , 116 words,  
Categories: Wellness, Health Plan Management, Incentives, Cost savings

Employee Wellness Incentives Help Lower Costs

Medical Costs PEPY

Participation in a wellness program can help a plan and its members in multiple ways. So when a MedBen WellLiving client expressed concern about the number of employees taking part in their program, it was decided to take a different approach. The plan introduced financial incentives to promote participation – and the results were great.

From 2013 to 2015, with the new incentive in place and plan enrollment holding steady, the group's Claims Experience dropped 36%. Not only that, but Medical Costs Per Employee Per Year (PEPY) fell 34% (see graph).

This is only one example of success through MedBen WellLiving. To hear more information about employer wellness cost savings, contact Vice President of Sales & Marketing Brian Fargus at


  05:53:00 pm, by MedBen5   , 131 words,  
Categories: News, Prescription, Cost savings

MedBen Rx Once Again Beats National Spending Trends


U.S. spending on prescription drugs rose 5.2% in 2015, according to Express Scripts, the nation's largest pharmacy benefit manager (PBM). But as is the case year after year, MedBen has bucked the national numbers, with an average pharmacy trend of just 2.5%.

MedBen trend accurately reflects what the employer is paying, unlike other benefit managers whose trend may include part of the rebate that a PBM or third party administrator is actually holding back for themselves. With MedBen, you can be assured that all rebate savings go back into your pocket... and the same applies to pharmacy discounts as well.

To get more information about the ways MedBen saves employers money on Rx spending, contact Vice President of Sales & Marketing Brian Fargus at

Read more about the 2015 drug spending report at Reuters.


  09:28:00 pm, by MedBen5   , 306 words,  
Categories: Wellness

The Balancing Act: Proportional Nutrients

food groups

Just like getting your annual wellness exam, getting your body the right nourishment is also an important factor in overall health. In fact, Medical News Today states that “anything that lives is dependent on energy, which results from the combustion of food” – in other words, the right nutrition.

Proper nutrition can also help to combat against different variances in chronic conditions, such as diabetes and high blood pressure.

There are seven major nutrients our bodies need nourishment from to function. Macronutrients are those we need to ingest larger portions of, including protein, carbohydrates, fiber, water and fats. Micronutrients, those we need smaller portions of, include vitamins and minerals.

Speaking of portions, remember that too much nourishment can be just as bad as not enough. The Portion Plate (shown right), developed by the U.S. Department of Agriculture, is a useful tool that can help to balance your diet. We’ve also included some tips in the green box below.

As always, MedBen WellLiving recommends speaking with your family physician about any concerns you may have regarding balancing nourishment for your body.

Ensuring the Right Portions
Here are some easy-to-remember ways to recognize the right portions on your plate.

  • Half of your plate should be covered by fruits and vegetables.
  • Go easy on fats, such as butter – make no bigger than a single poker chip.
  • 1.5 oz. of cheese is that of 3 dice.
  • 1/4 of your plate should be protein.
    - 3 oz. of fish is the size of a checkbook.
    - A deck of cards is equal to 3 oz. of chicken.
    - 1 oz. of lunch meat is the size of a compact disc.
  • 1/4 of your plate should be starch.
    - 3 oz. muffin or biscuit is the size of a hockey puck.
    - 1 cup of pasta is the size of a baseball.
    - 1/2 cup of rice is equal to a light bulb.

SOURCES: Medical News Today, WebMD, ChooseMyPlate.Gov


  05:49:00 pm, by MedBen5   , 188 words,  
Categories: News, Health Care Reform, Taxes, IRS

Study: Middle Class Will Bear Brunt of Cadillac Tax


A new study suggests that middle-class families will be hardest hit by the Affordable Care Act's unpopular "Cadillac" tax.

Investors Business Daily reports that the study indicates the excise tax — ostensively meant to discourage benefit-rich health plans with the threat of a non-deductible 40% surcharge on insurance premiums above $10,800 for individuals and $29,100 for families — will primarily affect families with incomes between $38,000 and $100,000.

According to study co-author Steffie Woolhandler, because middle-class families benefit the most from the current tax exemption to employer-provided insurance, they'll ultimately bear the brunt of the Cadillac tax.

The Cadillac tax has also been criticized for potentially impacting more modest health plans as their costs continue to rise at a pace faster than overall inflation. For these and other reasons, late last year President Obama approved a two-year delay of the tax's implementation until 2020.

Regardless of the delay, however, MedBen advises that employers continue to make whatever adjustments to their benefits necessary to manage health care cost increases. Clients who would like help determining their probability of being subject to the Cadillac tax are welcome to contact MedBen Vice President of Compliance Caroline Fraker at


  09:43:00 pm, by MedBen5   , 102 words,  
Categories: News, Prescription, Wellness

New CDC Guidelines Stress Painkillers as Last Resort

pill bottles

New national standards released by the Centers for Disease Control and Prevention recommend the prescribing of opioid painkillers only after other therapies have failed, reports STAT.

The CDC also suggests that if opioids must be prescribed, short-term treatment — from three days to no more than seven — is far more preferable than long-term use, as it reduces the risk of addiction. The guidelines focus on chronic pain except for cancer and end-of-life care.

Two million Americans abuse opioids annually, resulting in about 15,000 deaths by overdose every year. While the guidelines are voluntary, the CDC is hopeful that primary care doctors will follow them.


  08:20:00 pm, by MedBen5   , 269 words,  
Categories: Announcements

Clinical Claim Reviews Save MedBen Clients $4.4 Million in 2015


MedBen’s industry-leading clinical claim review process saved clients $4.4 million in 2015, using board-certified physicians to identify and eliminate unnecessary procedures and abusive practices, and opportunistic billing practices. MedBen is one of just a few third party administrators or carriers who can claim that 100% of its clients’ claims are scanned after taking available network, repricing and benefit reductions, but before the claim is paid in order to look for potential clinical problems on the claim.

“The difference is that we use over 150 board-certified physicians to look at claims in their area of expertise to ensure they are appropriate,” said Kurt Harden, President and COO of MedBen. “81% of the savings we found for clients were rooted out by a physician who noticed something wasn’t right with the claim.”

Many organizations claim to have coding software or use nurses to find claim issues. MedBen’s approach is very different, using a team of physicians to find everything from inappropriate implantable cardiac devices (ICDs) or pacemaker placements, to chemotherapy abuses and even inappropriate lab testing.

Recent news articles about hospitals settling with the Department of Justice on ICD placements, abusive lab practices, lower back surgery problems, and rehabilitation therapy abuses have highlighted the need for such reviews, but few organizations are able to deliver on the reviews. “Most organizations simply haven’t figured out a way to perform the reviews thoroughly and efficiently while staying within payment timelines,” said Harden. “We have a long-term relationship with many of these physicians along with the data history necessary to move the good claims along while flagging the problems and fixing them before they are ever paid,” Harden added.


  11:01:00 pm, by MedBen5   , 205 words,  
Categories: News, Health Plan Management, Cost savings

Spousal Coverage Surcharges Gaining Steam with Employers


A money-saving strategy that many MedBen clients have been using for years appears to be catching on in a big way. A new survey shows that the number of employers that discourage spousal coverage will likely more than double in the next two years.

Business Insurance reports that, according to the 2015 Best Practices in Health Care Employer Survey, 27% of employers reported using spousal surcharges for health care coverage when other employer-provided health insurance is available. That number is expected to rise to 56% by 2018.

Surveyed employers charge a $1,200 spousal surcharge on average, and 56% plan to increase the amount in 2017. Additionally, 3% of employers don't offer or have eliminated subsidies altogether for spousal coverage and another 10% plan to by 2018.

Spousal limitations enable employers to offer their workers a comprehensive health package while still respecting their bottom line. When outside coverage is readily available to many spouses, this strategy does makes good financial sense.

Of course, plan design change is just one of the ways MedBen saves clients money. Our cost control solutions range from leading-edge claims surveillance to an advanced reporting platform – all of which can benefit your business. For additional information about the MedBen Advantage, contact MedBen Vice President of Sales & Marketing Brian Fargus at


  11:11:00 pm, by MedBen5   , 224 words,  
Categories: Announcements, News, Wellness, Heart

MedBen Sponsors AHA HeartChase Fundraiser

MedBen is pleased to serve as a local sponsor of the 2016 Licking County (OH) HeartChase. Created by the American Heart Association (AHA), HeartChase is a community game that offers a healthy competition while raising funds to help fight heart disease.


At the event, which will be held April 30, 2016, MedBen and other area businesses will form teams to square off in a chase through the community. Participants will face multiple checkpoint challenges and locate Power Ups all while tracking progress in the HeartChase Mobile Game App, and gaining enough points to win.

"MedBen welcomes the chance to participate in these kind of fun events that bring the community out for a good cause," said MedBen President & COO Kurt Harden. "The prevention of heart disease through check-ups and healthy habits is something we encourage through our WellLiving program, so we're happy to take part in any public forum that spreads awareness."

Registration for HeartChase opens at 8:30 a.m., and game play begins at 10:00 a.m. The event will be held in the courtyard square in Downtown Newark.

If you're a Licking County business, we hope you will join MedBen and other local teams at HeartChase on April 30. And if you're outside Licking County, we encourage you to check and see if the AHA is offering a HeartChase in your area... or contact them to start one yourself!


  07:12:00 pm, by MedBen5   , 173 words,  
Categories: News, Health Plan Management, Provider Networks

HealthSpan Network Sold; MedBen Will Help Clients with Benefit Solutions

MedBen was recently informed of the sale of HealthSpan, which many of our clients use as a provider network in Southwest Ohio, Southeast Indiana, and Northern Kentucky. HealthSpan has agreed to sell its network and other lines of business to Medical Mutual of Ohio and will cease operations in January of 2017.

MedBen has talked with both HealthSpan and Medical Mutual of Ohio about this acquisition and has begun evaluating the best options for our clients. We have been a network partner with both organizations for over 15 years and believe this purchase will result in improved options for MedBen clients, along with a greater flexibility in benefit solutions.

Both organizations have indicated that nothing will change for the remainder of 2016, allowing us to work with brokers, consultants, and clients in the coming months to determine the best benefit solutions.

MedBen clients that currently offer the HealthSpan network can expect to hear from MedBen soon. In the meantime, clients with questions regarding the acquisition are welcome to contact MedBen President and COO Kurt Harden at (888) 633-2364.


  08:19:00 pm, by MedBen5   , 292 words,  
Categories: News, Health Plan Management, Health Care Reform

HHS Raises 2017 Out-of-Pocket Plan Maximums

HHS logo

Important news for employers looking ahead to 2017 benefit planning: The U.S. Department of Health and Human Services has raised the maximum out-of-pocket amount that health care plans can require plan members to pay next year, based on final regulations recently released by the agency.

Starting in 2017, the maximum out-of-pocket expenses employers can require employees enrolled in group plans to pick up will be $7,150 for single coverage and $14,300 for family coverage. That compares with 2016 limits of $6,850 for single coverage and $13,700 for family coverage.

According to Business Insurance, the proposed boost in the out-of-pocket limit is based on a methodology laid down by the Affordable Care Act (ACA) and is tied to increases in group health care plan premiums.

While we're on the subject of benefit planning, we'll take this opportunity to remind you of two notable ACA fees for the rest of 2016:

2016 PCORI (Patient-Centered Outcomes Research Institute) Fee

  • For plan years ending on or after October 1, 2015 but before October 1, 2016, the PCORI fee will go up to $2.17 per employee, spouse, and dependent on the plan.
  • For plan years ending on or after October 1, 2014 but before October 1, 2015, the PCORI fee will go up to $2.08 per employee, spouse, and dependent on the plan.

2016 Transitional Reinsurance Fee

  • $27 per every employee, spouse and dependent on the plan. This is the last year for paying this fee.
  • If you pay in one installment, full payment is due no later than January 15, 2017.
  • If you pay in two installment, the first payment is due no later than January 15, 2017, and the remainder is due no later than November 15, 2017.

MedBen clients who have questions regarding their plan's out-of-pocket maximums or ACA fees are welcome to call their Group Service Representative or Caroline Fraker, Vice President of Compliance & Chief Privacy Officer, at


  03:47:00 pm, by MedBen5   , 650 words,  
Categories: News, Health Plan Management, Health Care Reform, Third party administration, MedBen University

First MBU of 2016 Highlights Health Care Reform

MedBen University (MBU) launched its 2016 series of benefits management seminars with a well-attended session that offered an extensive look at the current state of the Affordable Care Act.

Entitled "Navigating the Health Care Reform Storm" and presented by MedBen Vice President of Compliance Caroline Fraker, the session covered a variety of topics, from 2016 plan design considerations to potential employer penalties and fees. Fraker also touched briefly on 1094 and 1095 reporting, a topic with she dealt with in depth at an MBU event last October.

MedBen University

One of the items discussed in some detail was ACA guidance offered to health care plans though the latest in a series of FAQs released by the U.S. Department of Labor. "These are sort of informal, 'this-is-what-we-really-meant-when-we-wrote-the-law' clarifications," Fraker said.

The 29th FAQ is something of a "pot luck" of health care reform issues. One noteworthy clarification pertains to preventive services: Any ancillary services to the preventive care, such as a follow-up to a mammography, must also be covered at 100%. "And they went even further to say that you can't impose a general exclusion in your plan that would impact a recommended preventive service," Fraker added.

The FAQ also requires that non-grandfathered plans must not only cover screenings for obesity in adults at 100%, but weight management services as well. However, Fraker noted, the guidance does allow for "reasonable medical management techniques," such as prior authorization and ensuring that a proposed treatment matches the diagnosis.

Full story »


  11:17:00 pm, by MedBen5   , 189 words,  
Categories: News, Health Plan Management, Hospitals, Cost savings, Heart, Research

Growing Focus on Outpatient Care Saving Health Plans, Consumers Money

A new series of studies show that employer health plans can save thousands of dollars by encouraging the use of outpatient facilities for certain medical treatments, Forbes reports.

The studies examined four common medical procedures – hysterectomy, lumbar/spine surgery, angioplasty and gallbladder removal – that cost health plan members and their employers $11 billion in 2014. Once performed strictly in hospitals and necessitating inpatient stays, advancements in medical technology now enable physicians to offer these procedures on an outpatient basis, saving plan and patient alike from the added costs associated with hospital stays.

outpatient cost comparison

As the table above demonstrates, the total per-procedure costs in 2014 for outpatient care was substantially lower compared to inpatient treatment, ranging from $4,505 for hysterectomies to $17,530 for angioplasties. Moreover, patients who chose the outpatient option also realized significant out-of-pocket savings.

While not all medical treatments are available on an outpatient basis, the number of procedures has grown in recent years, likely contributing to the slower rise in health care spending during the past decade. The ongoing shift away from fee-from-service care to a value-based system has also encouraged the health care industry to find more efficient methods of delivering medical services.


  11:39:00 pm, by MedBen5   , 323 words,  
Categories: News, Health Plan Management, Hospitals, Cost savings, Heart, Third party administration

More Hospital Settlements as Justice Department Ends ICD Investigation


The U.S. Justice Department has made its final round of settlements with hospitals suspected of excessive use of implantable cardiac devices (ICDs) following a five-year study. Meanwhile, MedBen has been protecting clients from this expensive practice for nearly a decade.

According to Modern Healthcare, 51 more hospitals – several leading hospital systems among them – will pay the government $23 million to end their probe into suspected overuse of ICDs. This follows a similar settlement in 2015 by 457 hospitals for more than $250 million.

ICDs are implanted near the heart to detect and treat arrhythmia – fast, life-threatening heart rhythms – by delivering a shock to the heart. Medicare allowed their for primary prevention of arrhythmia beginning in 2005, with the caveat that it wouldn't pay for devices implanted within 40 days of a heart attack or 90 days of bypass surgery or angioplasty. Even so, upwards of 40% are implanted contrary to clinical practice guidelines, when a less expensive pacemaker, or even medication, may have been sufficient to treat the condition.

MedBen follows research-based clinical criteria for appropriate placement of ICDs. Since 2007, we have employed cardiologists to perform clinical reviews on these devices on behalf of our clients, as a standard part of our clinical review process – and have saved clients $2.5 million in the process.

ICDs are among the most expensive devices to treat abnormal heart rate, costing $40,000 or more per unit, and need to be replaced every 5 years. Therefore, MedBen believes it essential to rely on expert physician reviewers to review charges like these that aren't caught by coding software and standard claim payment reviews.

MedBen's surveillance system flags claims for possible clinical issues like ICDs, in addition to a variety of other reasons, such as large loss potential for the employer or inappropriate provider billing. We focus on ensuring that our clients pay only for appropriate care, saving money for employer and patient alike.

Clients with questions regarding MedBen’s clinical review procedures are welcome to contact President and COO Kurt Harden at 888-633-2364.


  10:41:00 pm, by MedBen5   , 241 words,  
Categories: News, Security, Privacy

MedBen Uses Multiple Means to Guard Against Cyberattacks


A hospital in Los Angeles made national headlines recently when, following a cyberattack that disabled the facility's computer devices for over a week, it paid a $17,000 ransom to regain system access. However unusual the circumstances may seem, the threat of this type of attack is genuine, and it's the reason that MedBen employs multiple safety protocols to guard against it.

MedBen maintains constant vigilance against cyberattacks, using a series of external, internal and physical safeguards. Among the keys to our cybersecurity strategy are multiple layered hardware devices which prevent access to our internal networks. Additionally, all incoming and outgoing emails are scanned by a hardware device to detect and quarantine malware, and all devices accessing the Internet must pass through a hardware device that scans the traffic in either direction.

As a further measure of security, MedBen is subjected to an annual penetration test from an outside auditing firm. The timing of these tests and the manner in which they are executed is unknown to anyone at MedBen. The most recent breach attempt in 2015 proved unsuccessful – the same result as all previous tests.

The security and privacy of client information is of paramount importance to MedBen, as is ensuring uninterrupted systems operation. We make it our mission to earn your continuing trust in every way possible.

MedBen clients with questions regarding our cybersecurity measures are welcome to contact Vice President of Information Systems and Chief Privacy Office Rose McEntire at


  06:43:00 pm, by MedBen5   , 232 words,  
Categories: News, Health Plan Management, Health Care Reform

Despite ACA Alternatives, Employers Prefer to Offer Health Care Coverage


The introduction of state and federal insurance marketplaces through the Affordable Care Act has not deterred most U.S. employers from offering group health care coverage, Healthcare Dive reports.

According to a recent Kaiser Family Foundation survey, employers today still provide health care coverage to 147 million people, over half of the working-age population – virtually unchanged from 2015. A handful of smaller employers (4%) have switched some full-time employees to part-time status, but even more (10%) have done the opposite.

“Employers are very hesitant to drop health benefits,” said Paul Fronstin, director of the health research and education program at the Employee Benefits Research Institute. “They don’t want to be the employer that did so in a tight labor market.”

Large employers – those with 50 or more employees – must, under ACA rules, offer health insurance to 70% of full-time employees or pay a penalty. But that fact notwithstanding, employers cite other reasons for continuing to provide coverage, including the slow growth in health care costs during the past few years and concerns about provider availability through the public marketplaces.

Offering a customized health care plan also allows employers to promote wellness and ensure that employees have access to necessary benefits, said Fronstin: “They want them to come to work healthy and to be productive, and they may have their doubts about the public exchanges’ ability to give the kind of care that they think their employees need to get.”


  10:32:00 pm, by MedBen5   , 212 words,  
Categories: News, Prescription, Health Plan Management, Cost savings, Third party administration

MedBen Tops Central Ohio TPA Employee Survey

A new Columbus Business First survey reveals that MedBen is Central Ohio's leading third-party administrator, as ranked by local TPA employees. With 147 TPA employees residing in Licking, Franklin and surrounding counties, MedBen employs over 100 more local workers than the closest competition.

Business First TPA Survey

"As our home office has been based in Licking County for nearly eight decades, we've seen first-hand what a tremendous talent pool there is in Central Ohio," said Kurt Harden, MedBen President & COO. "And we're doubly fortunate that so many of them have chosen to work here and stay with MedBen for many years."

MedBen introduced third party administration in 1989, at a time when it specialized in traditional group health insurance. As the company evolved, it expanded its focus to cost-saving solutions for self-funded employers. The employee count grew accordingly, from about 25 employees in the late 1980's to its current number.

Harden says that employee growth is not merely a matter of needing more people to serve an ever-growing number of clients. "Over the years, MedBen has implemented a variety of ways to help clients save money, such as physician-directed claims surveillance and a groundbreaking pass-through prescription drug program. As such, we now have dedicated employees to ensure that our clients see the greatest financial return possible from these services."


  09:45:00 pm, by MedBen5   , 339 words,  
Categories: Wellness

February: The “Heartiest” of Months


Being that heart disease and stroke are the nation’s numbers one and five causes of death, MedBen WellLiving encourages individuals to seek proper care for their hearts. This includes at least one yearly visit to your family physician for a wellness exam, to monitor any changes with your heart or other areas of health.

According to the American Heart Association, 150 minutes of moderate (75 minutes of vigorous) physical activity per week reduces your risk of heart disease and stroke. Don’t be alarmed if you’re thinking, “I don’t have time for that” – physical activity is considered to be anything that gets your body moving and burns calories.

Going further than regular exercise, maintaining a hearty diet is also a necessity for a healthy heart. Eating foods such as fruits and vegetables, whole grains, or low-fat dairy products will help you to maintain an overall healthy diet. WebMD confirms that foods such as salmon, black beans, oranges, low-fat yogurt, and walnuts are proven to help save your heart.

Having a healthy diet and exercising regularly also help to improve or maintain one other major factor of your heart’s health: weight. There are many ways to check your BMI (Body Mass Index), which calculates an ideal weight range based on your height, but WellLiving suggests speaking with your physician about what a healthy weight means specifically for you.

Full story »


  10:14:00 pm, by MedBen5   , 259 words,  
Categories: News, Reporting, Hospitals, Cost savings, MedBen Analytics, Bundled Payments

As Providers Shift to Value-based Payments, MedBen Analytics Offers Actionable Insights

doctor at computer

The U.S. Department of Health and Human Services (HHS) is taking bold measures to move Medicare payments from the traditional model to alternatives based on the value of the services given. MedBen Analytics is currently working with providers nationwide to help them make this transition in a performance-efficient and cost-effective manner.

At the World Economic Forum Annual Meeting in Switzerland last month, Secretary Sylvia M. Burwell said HHS will meet their goal of moving 30% of fee-for-service Medicare payments to bundled payments and other value-based arrangements by year end. The agency has also set the goal of tying 50% of Medicare payments to alternative payment models by the end of 2018, Healthcare Dive reports.

HHS states that the use of alternative payment models has:

  • Saved Medicare a combined $417 million;
  • Reduced hospital readmissions in Medicare by nearly 8%; and
  • Through quality improvements, saved 50,000 lives and $12 billion in care spending from 2010 to 2013.

As bundled payments and other value-based payment models become more commonplace, and an ever-greater number of older Americans become eligible for Medicare, providers need to have the tools required to make informed decisions about the delivery of care. Toward this goal, MedBen Analytics turns claims data into actionable insights necessary to improve performance.

MedBen Analytics' proprietary analytics software takes the numerous and disparate Medicare files available to bundled payment initiative hospitals, health systems and physician practice participants and creates straightforward, interactive reports to benefit the provider of care as well as the recipient.

Organizations interested in discussing MedBen Analytics' services can call President and COO Kurt Harden at 888-633-2364 or email him at

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