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08/12/18

  04:24:00 pm, by MedBen5   , 230 words,  
Categories: Prescription, Wellness, Preventive care, Claims management, MedBen Rx, MedBen Rx Advocate, MedBen Rx Alliance

Million-Dollar Claims Continue to Rise, But MedBen Has Solutions

dollar sign magnified

The Affordable Care Act's elimination of lifetime benefit maximums has led to a surge in million-dollar medical claims, with the number nearly doubling in the past four years. It’s one more reason why MedBen is dedicated to developing savings strategies for self-funded employers.

The Sun Life Financial 2018 High-Cost Claims Report found that the number of patients with million-dollar claims rose 87% from 2014 to 2017. These claims added up to $935 million in paid charges, with cancer alone accounting for $798.7 million of that total.

Claims management is a critical element to countering high-costs claims, and MedBen’s advanced claims surveillance system has saved clients tens of millions of dollars over the last decade. But lowering costs doesn’t stop there.

A proactive savings approach begins with reducing the risk of cancer and other costly diseases from developing in the first place. MedBen WellLiving promotes the prevention and detection of chronic conditions through regular wellness exams and screenings.

Prescription drugs play an increasingly greater role in high-cost claims, and MedBen continually seeks out ways to combat rising drug prices. We recently introduced Rx Advocate and Rx Alliance, two programs that offer significant savings over traditional pharmacy plans. You can learn more about them at our new MedBen Rx website.

MedBen has 80 years of experience in saving clients money on even the costliest claims. Learn more by contacting Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

  07:37:00 am, by MedBen5   , 199 words,  
Categories: Wellness, Heart, Diabetes, Hypertension

Smoking Costs… Socially and Physically

cigarette smoker

The Department of Housing and Urban Development (HUD) recently implemented a nationwide ban on smoking inside or near public housing facilities. It’s just the latest step in an ongoing effort to provide smoke-free work and communal environments and protect people from secondhand smoke.

While smokers may be displeased by these actions, the social inconveniences of smoking are minor compared to its physical hazards. Smoking increases the risk of heart disease and stroke by 2-4 times, raises diabetes risk by 30-40%, and has also been linked to hypertension.

In addition, smoking costs Americans over $300 billion in medical costs and lost productivity every year. So not only will decreasing the amount of smoking that occurs reduce health risks, it will also lower health care costs substantially… and here, MedBen can help.

Specialty care offered through MedBen WellLiving uses individualized nurse coaching to help your plan members lower their risk of hypertension, heart disease, and other conditions associated with smoking. Moreover, we will work with employers to design wellness program incentives that promote a tobacco-free lifestyle.

To learn more about how MedBen WellLiving play an important role in promoting better workplace health, please contact Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

08/10/18

  01:42:00 pm, by MedBen5   , 235 words,  
Categories: Cost savings, Third party administration, Compliance, Self-funding, Regulatory

Self-Funding: Savings, Flexibility, Regulatory Freedom

MedBen building

There are plenty of benefits for employers who make the switch from fully-insured health care coverage to self-funding – and we’d be happy to share them all with you anytime – but perhaps the best reasons can be summed up quite simply: Savings, Flexibility and Regulatory Freedom.

Savings. Self-funded employers pay only for their actual health care expenses. It’s not uncommon for self-funded groups to realize savings of 10% or more annually over fully-insured coverage… and with MedBen’s proven cost containment solutions, employers can save even more.

Flexibility. Self-funded employers choose the health care plan options that work best for their employees. MedBen helps employers to make the most of this flexibility, using our benefits management expertise to assist in plan design that promotes cost-effective care.

Regulatory Freedom. Self-funding offers a greater degree of independence from state and federal regulations. And because every business is different, our expert Compliance Department works with clients one-on-one to ensure specific regulatory issues are being addressed.

Once your plan is in place, MedBen offers a variety of administrative features to help you take full advantage of self-funding, such as claim surveillance that ensures every claim is processed in accordance with your coverage, and actionable reports you can use to make informed plan decisions.

If your company is ready to benefit from self-funding, then make the switch with MedBen. Contact Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com for more information.

08/07/18

  06:57:00 pm, by MedBen5   , 292 words,  
Categories: Wellness, Preventive care, Primary care

“Just Talking” with Your Doctor

doctor-patient consultation

How many times have you heard someone say, “I’m not going to go to my annual wellness exam because I’m not sick”? Sure, we go to the dentist to have our teeth cleaned or go to the optometrist to have our eyes checked, yet when we go to the doctor for an annual wellness exam, we sometimes just talk about our ailments while they take our blood pressure. And just talking equates to nothing, right? MedBen WellLiving begs to differ.

“Just talking” with your doctor at an annual exam creates an open dialogue to create a professional patient-doctor relationship. During this exam, your doctor learns about your medical history, which in turn helps them to detect symptoms of early onset of chronic conditions, and to effectively intervene when necessary.

Studies have shown that early detection is key for a better prognosis and lower incurred costs – and speaking of cost, annual wellness exams are free when performed by an in-network physician. Some employers even offer incentives for members to get their exam by the end of the calendar year.

To check when you need to have your next wellness exam and other recommended screenings, just log in to MedBen Access and select “WellLiving Information.”

Full story »

07/29/18

  09:51:00 pm, by MedBen5   , 176 words,  
Categories: Announcements, Prescription, MedBen Rx Alliance

New Rx Alliance Program Uses Purchasing Power to Lower Drug Costs

pharmacist

MedBen recently introduced Rx Advocate, a unique pharmacy program that breaks from traditional plans by focusing on the average costs that pharmacies pay for prescription drugs, rather than using inflated wholesale prices. But Rx Advocate is just one of two new pharmacy solutions we're now offering.

Did you know that hospitals can purchase prescriptions drugs at a lower cost than even the largest of retail chains? MedBen Rx Alliance aligns the purchasing power of hospitals with the convenience of local pharmacies, providing qualified organizations with the lowest possible prescription prices available. While qualified organizations save on prescription drug spending, hospitals are building great relationships and showing their commitment to their communities.

Selected organizations qualify for MedBen Rx Alliance. To determine whether your organization is qualified, please call MedBen at (866) 623-2365.

There’s nothing quite like MedBen Rx Alliance and our expertise can help you understand it quicker. To learn more, contact Vice President of Sales and Marketing Brian Fargus at bfargus@medben.com. You can also get more information by visiting our new MedBen Rx website (more about that here).

  09:38:00 pm, by MedBen5   , 272 words,  
Categories: Announcements, Online Services, MedBen Rx, MedBen Rx Advocate, MedBen Rx Alliance

MedBen Rx Site Offers Two Unique Saving Solutions

Because prescription drug costs continue to play an increasingly large role in health care spending growth, MedBen has been working overtime to find saving solutions. Recently, we developed not one, but two new pharmacy programs to help clients lower their Rx spending... and we've got so much to tell you about them, we've dedicated an entire website to it.

MedBenRx.com showcases our two unique pharmacy programs:

  • Rx Advocate: Rather than starting high with an inflated wholesale price and working down, Rx Advocate starts low and stays there. By using the average cost pharmacies pay for drugs, the “cost plus” difference better reflects the drug’s actual price.
  • Rx Alliance: This pharmacy program builds partnerships that result in lower prescription prices and stronger communities. Rx Alliance helps qualified hospital purchase and distribute drugs at the lowest legal prices to qualified organizations.

Rather than describe everything available on MedBenRx.com, we invite you to visit the site and see for yourself. But we will tell you that in addition to program descriptions, you'll find such features as case studies, an Rx Report Blog, and an FAQ page. You'll also meet the people behind the plans, who have made it their goal to help you reduce your prescription drug costs.

Please take a few moments to browse MedBenRx.com to learn more about our pharmacy saving solutions. If you'd like to learn more about either program, contact Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com, And if you have any thoughts about the site content, we always welcome your comments and suggestions... feel free to drop a line to Senior Marketing Specialist Chuck Jindra at chuckj@medben.com.

  08:22:00 pm, by MedBen5   , 239 words,  
Categories: Social media

MedBen, Getting Even More "Sociable"

Twitter-Facebook-LinkedIn-Instagram logos

Earlier this year, MedBen expanded its social media presence, adding Facebook, LinkedIn and Instagram to its existing Twitter page. It's all part of our ongoing pursuit to give you the health benefits management information you need from as many sources as possible.

Whatever platform you prefer, you'll regularly find MedBen news, announcements, and updates, as well as links to health care industry-related articles we believe you'll find of interest. Also, all four services offer three recurring weekly features:

  • Motivational Mondays: Bits of inspiration and insight to start your work week off on the right note, and how MedBen can help you achieve your goals.
  • Health Tip Tuesdays: Useful advice covering a variety of wellness topics, such as food and diet advice, exercise hints, preventive care reminders, and suggestions for better mental health.
  • Throwback Thursdays: In observation of our 80th anniversary, we're scouring the MedBen archives for vintage photos and advertisements going all the way back to 1938. It's a fun glimpse back at how we've changed over the years, business-wise (not to mention, fashion-wise).

Social media is just one part of the MedBen communication chain. For over a decade, the MedBen Blog has been and continues to be a one-stop source for the latest MedBen, industry and regulatory happenings. Or you can get all the news sent directly to you through biweekly MedBen e-briefs newsletters. If you’re not currently on our mailing list, we invite you to sign up today!

  05:55:00 pm, by MedBen5   , 206 words,  
Categories: Wellness, Research, Preventive care

Better Health Begins with the Basics

woman eating healthy foods

Taking a proactive approach to wellness can dramatically cut your risk for heart disease and cancer, and even add over a decade to your life, a recent study suggests.

The analysis of 120,000 participants found that men and women who followed five healthy habits – eating healthy, exercising regularly, maintaining a healthy body weight, not smoking, and moderating alcohol consumption – were 82% less likely to die of cardiovascular disease and 65% less likely to die from cancer. In addition, adopting these habits can add an extra 14 years to the lives of women over the age of fifty and add an extra 12 years to the lives of men.

Preventive care goes hand in hand with healthy habits. This is why MedBen WellLiving encourages yearly checkups and age- and gender-appropriate cancer screenings as key elements of an employer’s overall wellness strategy. By helping employees to reduce their risk of heart disease and cancer, you benefit from a healthier, more productive workplace, and lower your long-term care costs as well.

Sticking to the basics may seem obvious, but it’s often the clear choices that make the biggest difference. Learn more about how MedBen WellLiving can aid you in promoting healthier lifestyles by contacting Vice President of Sales and Marketing Brian Fargus at bfargus@medben.com.

07/15/18

  11:01:00 pm, by MedBen5   , 173 words,  
Categories: Prescription, Online Services, Transparency, MedBen Rx, MedBen Rx Advocate

MedBen Rx, Truly Transparent

pills and bill bottle

If you’re a MedBen client, you already know that 100% of all paid manufacturer rebates go back to our clients. But true Rx transparency also demands that consumers know what they're paying for their medications – and so we provide that, too.

Simply by logging into our online service center, MedBen Access, pharmacy plan members can see exactly what their copay is for all prescribed drugs. In addition, patients can review their prescription purchases and get detailed information about thousands of drugs. The site even allows users to research and compare brand-name drug prices with lower-cost generic and therapeutic alternatives.

Moreover, for employers using the MedBen Rx Advocate program, their employees will see even lower copays. The "cost plus" difference means that drug prices are based on what the pharmacy pays rather than their inflated wholesale prices. These savings average 11% per drug, but in the case of higher-price medications, member savings can be substantial.

For additional information about MedBen Access and MedBen Rx Advocate, contact Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

07/13/18

  09:38:00 pm, by MedBen5   , 188 words,  
Categories: Health Care Reform

Did You Know... 2019 ACA Limits

Capitol-Caduceus-Money Collage

The following limitations and penalties apply as of the first day of your plan’s 2019 plan year per the Affordable Care Act (ACA):

Standard Plan Out-of-Pocket Maximums

  • $7,900 for self-only (employee-only) coverage
  • $15,800 for other than self-only coverage

(Over these thresholds, employers must pay 100% of the benefits covered by the plan.)

High Deductible Plan Out-of-Pocket Maximums

  • $6,750 for self-only (employee-only) coverage
  • $13,500 for other than self-only coverage

(Other than preventive, all services must be paid by employee until above thresholds are met, then employers must pay 100% of the benefits covered by the plan.)

Employer-Shared Responsibility Penalties

  • $2,500 per employee (for all employees combined) if qualifying coverage is not offered to 95% of the employer’s employees working 30 or more hours per week
  • $3,750 per each employee for whom the employer-offered coverage is deemed unaffordable

Affordability Safe Harbors

Employee cost-share for employer-offered coverage must be less than 9.86% of one of the ACA safe harbor amounts (federal poverty level, W-2 salary or hourly rate of pay) for cost-share to be deemed affordable.

  • $12,140 – Federal Poverty Level (FPL) Safe Harbor Amount for 2019

MedBen clients who have questions regarding 2019 ACA limits may contact Vice President of Compliance Caroline Fraker at (800) 851-0907 or cfraker@medben.com.

  05:31:00 pm, by MedBen5   , 211 words,  
Categories: Wellness, Reporting, Heart, Diabetes, Hypertension

Wellness Exams Promote Prevention… and Exercise

runners on treadmills

If you get in half-hour cardio workouts five times per week, consider yourself a member of an exclusive group... unfortunately. Because according to new data from the Centers for Disease Control and Prevention, less than a quarter of U.S. adults get enough exercise.

Forbes reports that nationwide, only 22.9% of adults aged 18-64 meet current Health and Human Services guidelines that recommend 150 minutes of moderate-intensity aerobic physical activity every week, coupled with twice-weekly muscle strengthening activities. Broken down by gender, 27.2% of males meet the guidelines compared to 18.7% of females.

MedBen WellLiving promotes annual wellness exams from your family doctor as a way to prevent and detect chronic conditions, but that’s hardly the only benefit of regular visits. In recent years, physicians have increasingly prescribed exercise to help patients maintain or improve their health -- and research shows that overweight patients are nearly five times more likely to exercise if their doctors advise them to do so.

Regular exercise is a proven method to reduce the risk of heart disease, high blood pressure, type 2 diabetes, and other chronic conditions. Plus, a good workout makes you feel better and look better. So, wins all around!

Find out more about the benefits of MedBen WellLiving by contacting Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

07/11/18

  03:29:00 pm, by MedBen5   , 257 words,  
Categories: Announcements, Compliance, MedBen Employees

MedBen Names Kelly Director of Compliance and Medical Management

Erin Kelly, MedBen Director of Compliance and Medical Management

MedBen is pleased to announce the promotion of Erin Kelly to Director of Compliance and Medical Management. Kelly most recently served as Compliance Manager for the Newark, Ohio- based benefits management company.

Kelly started at MedBen as a Customer Service Representative in 2007, and also served as a Group Service Rep before joining the Compliance Department in 2011. Her client service history and knowledge of health plan language provided a strong foundation for her Compliance duties, said Vice President of Compliance Caroline Fraker.

"Erin has worked hard to understand and implement employee health plan regulations and to educate both our employees and our clients on related compliance issues," Fraker said. "And she has implemented new processes, including those in the Medical Management Department, to streamline work flow. So, this promotion is well-deserved."

In her new role, Kelly will oversee the interpretation and implementation of health plan regulations pertinent to MedBen clients as well as its own employees. She will also be responsible for educating clients and MedBen employees on regulatory requirements, including HIPAA, ERISA, and the Affordable Care Act.

"In addition to directing the daily operations of Compliance and Medical Management, Erin will continue to draft plan documents and SBCs [Summaries of Benefits and Coverage] to ensure that our clients follow state and federal rules to the letter," Fraker said.

Kelly holds a Bachelor of Arts degree from George Mason University and a Health Insurance Associate (HIA) designation from America's Health Insurance Plans (AHIP). She is an active supporter of the American Red Cross and Licking County Humane Society.

07/01/18

  03:23:00 pm, by MedBen5   , 237 words,  
Categories: Prescription, Wellness, Cost savings, Research, Third party administration, Preventive care, Compliance, Trend

Beating Cost Trend Difficult, But Not Impossible

dollar symbol on chart

"Healthcare costs increasing at unsustainable pace," a recent Modern Healthcare headline reads. In a new study, PricewaterhouseCoopers predicts a 6% medical cost trend in 2019, as expensive new medical services and drugs and market consolidation make it difficult for employers to contain their employee coverage costs.

But "difficult" is not "impossible," as MedBen clients regularly demonstrate. From 2013 to 2017, MedBen’s overall block of self-funded clients experienced an average claims cost trend of just 4.1%. Hospital and municipality clients did better still, realizing average claims cost trends of 3.1% and 2.7%, respectively.

So how do our clients consistently keep their health care spending under national trends? By strategic use of MedBen's variety of benefits management services and their associated cost reduction tools, including:

  • Medical claims management that uses an innovative surveillance system to track down questionable claims, backed by certified medical specialists;
  • Pharmacy benefits management that pays for medication based on what the pharmacy paid for it, not an inflated wholesale price;
  • Population health management that promotes early prevention and detection of chronic conditions through the doctor-patient relationship; and
  • An experienced compliance team that ensures client health plans meet federal and state regulations, so to avoid expensive legal complications.

Of course, these are just a few of the ways MedBen works with employers to design and maintain a cost-effective health plan. If you’d like more information about any of our saving solutions, please contact Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

MedBen Closed On July 4th, but MedBen Access Stays Open

MedBen closed July 4, reopens July 5

Happy Independence Day from MedBen!

In observance of the holiday, our home office will be closed on Wednesday, July 4 and reopen at 8:00 a.m. on Thursday, July 5. Hopefully your day off is all about cookouts with friends & family and community fireworks... but should you need claims or benefits information, our online customer service center, MedBen Access, is open for business!

MedBen Access offers a number of useful management functions, such as ordering ID cards, monitoring claims activity and reviewing change of information requests. Plan members can check a claim's status, review Plan Document coverage and download forms, to name just a few of the 24/7 services available.

Additionally:

  • Most pharmacy plan members will find a "My Rx Claims" link on the left sidebar that allows them to review their prescription drug purchases, get medication information and compare brand name drug prices with generic and therapeutic alternatives;
  • Participants in an FSA or HRA can use MedBen Access to see their balances, claims submissions and payments by selecting the "FSA/HRA Online Inquiry" option under "My Plan"; and
  • MedBen WellLiving members can check their compliance with annual exams and cancer screening tests by selecting the MedBen WellLiving link under "My Plan."

The entire MedBen team wishes you a safe and relaxing 4th!

06/30/18

  09:24:00 pm, by MedBen5   , 217 words,  
Categories: Wellness, Incentives, Research

A Little Wellness Incentive Goes a Long Way

doctor consulting with patient

National figures indicate high chronic condition costs and low wellness compliance. This comes as no surprise to MedBen, knowing that there is a direct connection between untreated (or even undetected) diseases and increased health care costs. But a little incentive can help your workplace improve compliance while reducing costs.

According to a new Milken Institute study, U.S. health care costs for heart disease, diabetes, and other chronic diseases totaled $1.1 trillion in 2016 ($3.7 trillion when factoring in lost productivity). Meanwhile, Health Affairs reports that only 8% of U.S. adults age 35 and above receive all recommended wellness exams and screenings.

MedBen WellLiving has found that incentivizing plan members to practice healthy habits can spur participation. In 2017, first-year WellLiving clients who offered premium-related incentives saw an average 29% increase in wellness compliance.

Incentives can take a variety of forms. In addition to offering lower premiums to members who show a wellness commitment, an employer can contribute to an HRA or FSA, or tie WellLiving to your health plan’s wellness benefits. But rewards need not be monetary, and even offering modest incentives (i.e., newsletter recognition, sponsoring a companywide competition) can impact participation.

MedBen WellLiving will help you develop a focused wellness program that drives participation, leading to long-term savings. Find out more by contacting Vice President of Sales and Marketing Brian Fargus at bfargus@medben.com.

06/29/18

  09:18:00 pm, by MedBen5   , 435 words,  
Categories: News, Health Care Reform, Self-funding

DOL Rule Expands Association Health Plan Access

Department of Labor logo

On June 19, 2018, the U.S. Department of Labor (DOL) released its final regulations expanding the definition of “employer” under ERISA Section 3(5). This seemingly simple change to an existing federal regulatory definition paves the way for the creation of additional Association Health Plans (AHPs) under ERISA and broadens the opportunity for health care plan coverage for small business owners and self-employed individuals. Prior to this Final Rule, AHPs existed but were subject to stricter regulatory criteria which limited the ways in which small employers could organize to form large group plans.

The DOL accomplished these changes by modifying its definition of “employer” under ERISA – the same definition that is used to define Multiple Employer Welfare Arrangements (or MEWAs). For purposes of ERISA, “employer” is defined as “any person acting directly as an employer, or indirectly in the interest of an employer, in relation to an employee benefit plan; and includes a group or association of employers acting for an employer in such capacity.” Prior to the Final Rule, the term “association” referred to a “bona fide” association which – having met certain criteria – would allow it to be treated as a single employer under ERISA.

Under ERISA, an employer can sponsor a single employee welfare benefit plan that provides benefits to its employees. However, grouping multiple single employers together to sponsor one plan triggers the ERISA MEWA rules along with complicated state regulatory requirements. The Final Rule does not eliminate the MEWA requirements, but it does expand the options for employers, including the self-employed, to band together to create a single association (or MEWA) health plan. The Final Rule also expands protections for AHP participants that are common in single-employer plans, such as covering preventive services at 100% and requiring compliance with the HIPAA non-discrimination rules.

While the Final Rule itself is effective August 20, 2018, the rules stagger applicability dates, as follows:

  • September 1, 2018 – The date the Final Rule becomes applicable for any existing fully-insured AHPs.
  • January 1, 2019 – The date the Final Rule becomes applicable for any existing self-funded AHPs that are already in compliance with the DOL’s previous sub-regulatory guidance on bona fide associations, and that choose to expand the association and its plan pursuant to the terms of the Final Rule (e.g., expand to a broader group of individuals, such as working owners without employees).
  • April 1, 2019 – The date the Final Rule becomes applicable for any new self-funded AHPs formed pursuant to and in compliance with the new rule.

Learn more about AHPs, MEWAs and the Final Rule by downloading a summary from MedBen.com. MedBen clients with questions are welcome to contact Vice President of Compliance Caroline Fraker at (800) 851-0907 or cfraker@medben.com.

Fraker, SPBA Members Talk Transparency in D.C.

Caroline Fraker in Washington DC, June 19, 2018

On June 19 and 20, MedBen Vice President of Compliance Caroline Fraker revisited Washington, D.C. with fellow members of the Society of Professional Benefit Administrators (SPBA) Board of Directors, to speak with government officials on matters of importance to self-funded employers.

In addition to discussions with multiple Congressional offices during their visit, the group met with Jim Parker, Senior Advisor for Health Reform, Department of Health & Human Services, to address health care price transparency. “We were pleased to have a chance to talk to Mr. Parker about an issue that directly affects the ability of employers to control their health costs,” Fraker said.

The Affordable Care Act includes language requiring greater price transparency, but little effort has been taken by the federal government to provide consumers with medical cost information. Such inactivity hinders the ability of patients to make informed decisions about the care they receive, Fraker noted.

“Today’s health plans are designed to encourage and empower the consumer to make smart health care choices, but they need the tools to do that,” Fraker said. “The SPBA is offering its expertise as a non-political resource, to help legislators and other officials develop the means by which providers can list their prices.”

Fraker was among the SPBA Board members who also met with Congressional offices in April. The Board hopes to schedule regular follow-up meetings.

Formed in 1975, SPBA strives to advance the goals of benefits administrators as well as to provide advice that helps members better serve their clients and their clients’ plans. SPBA Board members meet monthly via conference call to discuss issues of importance to the Society’s members and their customers. Board members also host twice-yearly conferences open to all SPBA members, which are preceded by Board-only meetings.

A 30-plus year veteran of employee benefits, Fraker assists MedBen clients with regulatory compliance, contractual and risk management issues. In addition to her SPBA responsibilities, she also serves on the Government Affairs Committee of the Licking County Chamber of Commerce.

06/25/18

  07:26:00 pm, by MedBen5   , 315 words,  
Categories: Wellness, Cancer, Preventive care

Importance of Colon Cancer Screening

Doctor-Patient Chat

Earlier this year, the American Cancer Society (ACS) lowered its recommended age for initial colorectal cancer screening from age 50 to 45. MedBen WellLiving however, will continue to follow the guidelines stating those 50 and older should be screened once every ten years, unless recommended otherwise by a physician. Nonetheless, this change references what MedBen has been saying all along: Get a colonoscopy!

ACS estimates that this year alone, 97,220 new cases of colon cancer will surface in the United States, and that colon cancer is the second leading cause of death due to cancer – so it’s easy to see why colonoscopies are significant. The earlier a disease such as cancer is detected, the better the prognosis and the smaller the cost of treatment.

During this painless procedure (that you’ll likely not even remember due to anesthetics), your doctor will examine your large intestine for possible causes of things like abdominal pain, rectal bleeding, or changes in bowel habits – and for those over 50, they are used to screen for colorectal cancer.

Remember, too, that some benefits plans offer incentives such as lower premiums for individuals who are compliant on receiving a colonoscopy. You can check your colonoscopy compliance, as well your compliance with other recommended screenings, by logging on to MedBen Access.

Full story »

06/17/18

Harden CEO Promotion Spotlighted in Columbus Business First

Kurt Harden, MedBen President & CEO

In a new Columbus Business First article, reporter Carrie Ghose interviewed MedBen President Kurt Harden and Executive Chairman Doug Freeman about Harden's recent promotion to CEO as well as the company's recent activities and future plans.

Freeman noted that Harden's promotion was part of an ongoing leadership transition plan. “As we have grown and diversified, Kurt has been personally in charge of those growth projects,” he said. “It was obvious he was going to be the guy who took over.”

In addition to managing MedBen's third party administration (TPA) and worksite wellness services, Harden spearheaded the creation of MedBen Analytics, a bundled payment reporting platform that converts Medicare data into actionable insights. In doing so, MedBen has expanded its client base to include hospital billing systems.

As the article mentions, Harden has also led recent changes to MedBen's pharmacy program and dental coverage.

The interview also touched on the financial aspects of the company's evolution from traditional group health insurance to administrative services for self-funded employers. Putting the focus on self-funding offered clients greater freedom in plan design and cost control, in addition to offering greater financial predictability for MedBen. As a TPA, "you know what your costs are," Freeman said.

Read the full article at the Columbus Business First website.

  08:13:00 pm, by MedBen5   , 229 words,  
Categories: News, Cost savings, Pharmacy benefit manager (PBM)

Government Talks about Rx Costs, But MedBen Already Has Solutions

pharmacist dispensing pills

During recent testimony to a Senate committee, Health and Human Services Secretary Alex Azar floated the idea of eliminating the rebates that drug companies and pharmacy benefit managers (PBMs) use in price negotiations. As noted on Bloomberg.com, "PBMs have been criticized for keeping some of the rebates for themselves instead of passing them directly to consumers to lower their out-of-pocket costs."

As long-time MedBen clients know well, when it comes to drug rebates, we believe in total transparency – and we partner with PBMs who share our philosophy. Therefore, employers can be certain that 100% of paid rebates are returned to their plan.

In his testimony, Azar also commented that he thinks that instead of offering rebates, PBMs and drug companies should just negotiate fixed-price contracts. “Such a system’s incentives, detached from artificial list prices, would likely serve patients far better,” he said.

As it happens, MedBen Rx Advocate program takes a very similar approach to what Azar is proposing. Rather than using an artificially inflated average wholesale price, Rx Advocate takes the actual average cost the pharmacist pays for the drug and adds a reasonable dispensing fee as compensation. Straightforward, fair, and reduces the employer's pharmacy spending by an average of 11%.

While the government searches for solutions to high drug costs, MedBen already has them. Find out more by contacting Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

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