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  04:15:00 pm, by MedBen5   , 209 words,  
Categories: Cost savings, MedBen Analytics, Bundled Payments, Reference-based pricing

Bundled Payments: The Future of Health Care Reimbursements?

roll of $100 bills

Health care payers are continually looking for ways to reduce medical spending. One idea that has gained traction in recent years is the bundled payment system, in which a provider is paid for a complete episode of care, rather than paid separately for the various services that make up that episode.

For the payer, bundled payments reduce total spending by eliminating treatment redundancies and inefficiencies. But in switching from traditional fee-for-service to a value-based approach, providers can also see financial rewards, by reducing their service costs through a focus on quality care.

Medicare has been a high-profile proponent of bundled payments, testing both voluntary and mandatory provider models. In 2015, MedBen introduced MedBen Analytics, a bundled payment reporting platform that converts Medicare data into actionable insights.

MedBen also offers commercial bundled payment services to clients. As health care systems become more comfortable with the value-based model, MedBen expects it to become the norm for employer claim payments. Self-funded plans will realize lower costs without compromising quality of care.

In addition to bundled payment services, MedBen offers a variety of alternative cost-saving strategies, such as direct-to-employer contracting and reference-based pricing. Contact Vice President of Sales & Marketing Brian Fargus at to discuss what strategies may work best for your business.


  07:27:00 pm, by MedBen5   , 293 words,  
Categories: Announcements, News, MedBen Employees

Fouch Among MedBen Employees Celebrating Benchmark Anniversaries

Anita Fouch

At an employee appreciation luncheon on September 14, MedBen employees who have reached noteworthy anniversaries were honored for their achievements... among them, Director of Accounting Operations Anita Fouch, who has served our clients for an impressive 30 years.

Anita worked her way up at MedBen, starting in 1988 as company receptionist. She later performed various jobs in the Administration and Billing Departments before becoming an Accounting Manager in 2004. She was named a Director in 2012.

Asked after the event what she enjoyed most about working at MedBen, Fouch replied that she appreciates the company's work ethic and family values. "MedBen recognizes everyone on a personal level, providing a great support system for me as an employee and as a parent,” she said.

Fouch added that she also likes the employee camaraderie at MedBen, which stems from its stable work environment. "I still love to get up in the morning and come do my job, while enjoying the company of the great co-workers and friends that I have the opportunity to work with every day," she said. "I’m very blessed."

MedBen 25th Anniversary celebrants

In addition to Anita's 30-year benchmark, three MedBen employees were singled out for their 25 years of service to MedBen. These include (in alphabetical order):

  • Arleen George, Provider Tech Support Specialist I;
  • Chuck Jindra, Senior Marketing Specialist; and
  • Bobbie Painter, Director of Claims.

(More about our 25th Anniversary celebrants soon!)

Other MedBen employees honored at the luncheon include:

  • 20 Years of Service: Tammy Jones, Tina Peck, Billie Rotert, Char Schaffner, Michelle Schmus, Kelly Stare and Tessie Young.
  • 15 Years of Service: Dan Bednar, Wendell Crain, Dru Ann Drake and Jeanne Olsen.
  • 10 Years of Service: Jennifer Baughman.
  • 5 Years of Service: Katie Dunn, Kim Dunn, Jessica Moore, Lori Phillis and Katrina Wilson.

Congratulations to everyone celebrating a benchmark anniversary with MedBen this year!


“New” Drug Pricing Tools? Not for MedBen

pharmacist prepping prescriptions

A Managed Healthcare Executive article spotlights "New Drug Pricing Tools" that could save patients and health plans money -- among them, a recently launched "real-time benefits tool" that shows out-of-pocket costs for medications based on a patient's plan benefits. Sound like a great idea... which is why MedBen has already offered it for years.

Our online MedBen Access service provides pricing transparency by allowing plan members to find the costs and copays of specific drugs, as well as costs and copays for any generic and therapeutic alternatives in the drug class. In the case of high-price medications, they can see substantial savings.

In addition to cost checks, MedBen Access allows members to review their prescription purchases and get detailed medication information. To use these features, just go to and click on "MedBen Access." Once you've logged in, select "My Rx Claims."

Pricing transparency is just one way that MedBen helps clients reduce their pharmacy plan costs. We now offer two innovative saving solutions: Rx Advocate, which bases pricing on the average actual costs that pharmacists pay for drugs; and Rx Alliance, which brings together hospitals and pharmacies to offer substantially lower drug pricing for qualified employers. Visit to learn more.

Learn more about MedBen Rx pricing tools by contacting Vice President of Sales & Marketing Brian Fargus at


  06:41:00 pm, by MedBen5   , 241 words,  
Categories: Wellness, Reporting, Cost savings, Preventive care, Primary care

Why the Right Wellness Approach Matters

doctor and patient

A recent wellness study confirms something that MedBen has known for a long time: If you want your workplace wellness program to succeed, the "physician first" approach is the way to go.

According to BPS Research Digest, researchers analyzed a university’s wellness program that used on-site biometric screenings and health risk assessments (HRAs) to track member health. After one year, the study compared the health of the program participants to that of a control group... and not surprisingly, found little difference between the two.

But really, MedBen could have saved the researchers the trouble. When we introduced a wellness program a decade ago, we learned early on that the on-site biometric screening is an ineffective means of promoting better health, as it lacks the ongoing doctor-patient dynamic. And self-reported HRAs in which respondents often exaggerate or falsify their health status contribute little.

MedBen WellLiving subscribes to the "physician first" approach because we have found that maintaining the doctor-patient relationship is key to continued good health and lower care costs. But we also understand that employers expect viable results from their wellness program, so we measure wellness success using multiple factors, such as member compliance with recommended tests. We analyze the numbers with our wellness clients on a regular basis to ensure that the program is fulfilling expectations.

Learn more about the MedBen WellLiving approach to your employees' better health by contacting Vice President of Sales & Marketing Brian Fargus at

  06:27:00 pm, by MedBen5   , 131 words,  
Categories: Announcements, Online Services, MedBen Employees

MedBen Closing Early on September 14

MedBen building

On Friday, September 14, MedBen will be closing at 12:30 p.m. EST for a company employee recognition event. We will reopen at 8:00 a.m. EST on Monday, September 17.

At the event, MedBen will pay tribute to employees who are celebrating benchmark anniversaries with MedBen... including several who have now been with us for 25, and even 30, years! (More about that soon.)

Remember that even when live service representatives aren't available, many of your questions (including those pertaining to prescription plans, FSAs and HRAs) can be answered anytime, anywhere through our MedBen Access website.

Also keep in mind that offers resources frequently requested by customers, such as a list of FSA-eligible expenses and instructions for reading EOBs. Just select the "Plan Sponsors" or "Plan Members" button on the home page, depending on your specific needs.

  06:22:00 pm, by MedBen5   , 212 words,  
Categories: Wellness, Cancer, Heart, Diabetes, MedBen Employees

MedBen Takes a Stand Against Sitting

stand-up desk

Computers, tablets, and smartphones have certainly made life easier, but it's also made us more sedentary... and all that idle activity isn't helping our collective health.

Sitting for prolonged periods of time increases your risk of heart disease, diabetes, and cancer, says David Alter, MD, Ph.D, a heart expert from the University of Toronto. And while regular exercise helps alleviate the danger somewhat, it's just as critical to get out of your seat for longer periods.

To assist employees wanting to lower their risk of chronic conditions, MedBen now provides stand-up desks on request. According to Dr. Alter, the target is to decrease sedentary time by two to three hours in a 12-hour day.

MedBen also encourages regular breaks away from the computer. Our company's personal well-being program offers simple stretching and light weight activities that employees can perform at their desk, with the added incentive of earning extra vacation time.

Of course, preventive care is vital for reducing medical risk. The perfect complement to exercise and smart work habits is an annual wellness exam, and MedBen WellLiving can help your business promote better employee health. To learn more about our wellness program and wellness incentives, we invite you to contact our Vice President of Sales & Marketing Brian Fargus at


  06:59:00 pm, by MedBen5   , 178 words,  
Categories: Flexible spending accounts (FSAs), Debit cards, Health reimbursement arrangements (HRAs)

MedBen FSA/HRA Debit Card Gets a Makeover

MedBen FSA-HRA Debit Card

The MedBen FSA/HRA debit card is getting a new look! The color has changed from red to blue and now sports a “cloud” logo in the upper left corner.

So when can you expect to get your new card? If you’re a new FSA/HRA client or new enrollee who hasn’t received your debit cards yet, expect to receive your “blue” cards soon. (Plan participants will each receive two cards.) Current FSA/HRA cardholders will receive replacement cards when the “Good Thru” date on their current card approaches, or if they lose their card and/or request a replacement.

To activate your new card, simply follow the instructions on the activation sticker, located on the front of the card.

Remember, your MedBen FSA/HRA debit card is a convenient way to pay for qualified health care expenses. Just use it as you would a regular debit card, to pay for eligible medical care, goods, and services at providers and merchants that accept Visa cards.

If you have any questions about your MedBen debit card, please contact MedBen Customer Service at (800) 297-1829 or


  07:16:00 pm, by MedBen5   , 174 words,  
Categories: Reference-based pricing, Contracts, Partners Community Health Plan

Direct-to-Employer Contracting Nothing New for MedBen

signing contract

A recent article opined upon the growing trend of employers contracting directly with health care providers. Such relationships, author Max Nisen notes, save employers money by giving them "a greater degree of control and flexibility in how they manage health-care costs."

But at MedBen, such relationships are hardly a new phenomenon... in fact, we have been facilitating direct-to-employer contracting for nearly a decade. Our various direct-to-employer strategies have brought together area businesses and hospitals, in designs that promotes the use of quality local care at a lower cost.

Most recently, MedBen has contracted with multiple health systems to accept reference-based pricing (RBP) plans. By using these providers, employers and plan members pay for medical services based on the true cost of care. And providers receive a fair and fast payment, so everyone benefits.

Direct-to-employer contracting is just one of the ways that MedBen can help clients save money on their health care. To learn more about it and other benefits management solutions, contact Vice President of Sales & Marketing Brian Fargus at

We're Closed Labor Day, But Online Services Stay Open

U.S. flag

Happy Labor Day from MedBen…we hope everyone enjoys the three-day weekend and sends out the summer on a high note!

We’ll be closed on Monday, September 3 to celebrate the holiday and will reopen at 8:00 a.m. on Tuesday, September 4. Hopefully, health care benefits won’t be a priority on Labor Day… but should you have a burning question, we invite you to take advantage of the variety of online customer services available at our MedBen Access website.

If your group offers an FSA or HRA option, we’d like to point you to a particularly useful feature of the site. By clicking on “FSA/HRA Online Inquiry,” you can look at your most recent claim submissions, review payments issued, see your total deposits posted to date and get answers to a whole host of questions.

Hard though it may be to believe, 2014 is two-thirds of the way over… so if you’ve got an FSA, you may want to consider making plans for spending the remaining funds in your account before your plan’s established deadline (usually December 31). Check MedBen Access to see what you’ve got left, then head over to the IRS-Eligible Expenses page on to research ways of using those unallocated dollars!

  05:42:00 pm, by MedBen5   , 162 words,  
Categories: Cost savings, Reference-based pricing, Dialysis

Costly Dialysis Legislation Should Spark Plan Language Change

kidney dialysis

If you've been on the fence about having MedBen help you implement proprietary health plan language for dialysis services, now is the time to act.

The American Journal of Managed Care reports that recent House of Representatives legislation includes a provision that would extend the Medicare end-stage renal disease (ESRD) waiting period an additional 3 months (to 33) before Medicare becomes primary payor. For employer health plans, this represents hundreds of millions of dollars more in added costs.

However, by implementing proprietary dialysis health plan language, employers can realize a substantial savings on the procedure. One MedBen client who amended their plan reported that their dialysis costs fell by 80%.

If you're a MedBen client who would like more information about adding MedBen’s proprietary dialysis plan language to your plan, contact Vice President of Compliance Caroline Fraker at (800) 851-0907 or Or you're interested in learning more about other benefits management solutions available through MedBen, contact Vice President of Sales & Marketing Brian Fargus at

MedBen Rx: Lessons in Savings and Transparency

prescription drugs

A recent headline refers to U.S. prescription drug pricing practices as "Lessons in Obfuscation." Unlike most products that have clearly defined prices, prescription drugs start with an acquisition cost paid by the pharmacy, which it then inflates and negotiates down with a pharmacy benefit manager. The result: Drug prices that can vary widely from one health plan to another.

MedBen prefers a drug pricing approach with a lot less guesswork, which is why we now offer pharmacy solutions through MedBen Rx. We've developed two unique programs with one common purpose: To provide clients with reduced drug costs and complete transparency.

MedBen Rx Advocate turns the standard list-price negotiation scenario around by using the average actual cost that the pharmacist pays for a drug and adding a reasonable dispensing fee. The pricing starts low and stays there.

MedBen Rx Alliance uses hospital purchasing power to offer substantially lower drug pricing for qualified employers through local pharmacies. It's a community partnership in which every participant benefits.

The article also states that, in regard to drug rebates, "what amount ultimately [gets] passed through to the end-user remains a carefully guarded trade secret." But again, that's not the case with MedBen Rx: 100% of paid rebates go back to the client. Total transparency.

Find out more about MedBen Rx pharmacy solutions by visiting or by contacting Vice President of Sales & Marketing Brian Fargus at


  05:31:00 pm, by MedBen5   , 198 words,  
Categories: Wellness, Cancer, Research, Preventive care

Cancer Screenings Down, But Wellness Focus Helps Defy Trends

cancer definition

The number of Americans getting screened for cervical, breast, and prostate cancers has declined in recent years, suggests a recent study by the U.S. Centers for Disease Control and Prevention (CDC).

The review of self-reported screenings from 2000 to 2015 found that Pap tests fell 4%, mammograms decreased 3%, and PSA tests dropped 5%. Colon cancer screenings did increase during the period studied, but still came up short of federal target levels.

The CDC focused on these four forms of cancer for good reason: They collectively account for about 40% of new cancer diagnoses and 20% of all cancer deaths. It's the same reason that the MedBen WellLiving wellness program focuses on these screening tests as essential elements of preventive care.

By promoting screenings and annual wellness exams as part of an overall wellness strategy, employers encourage a healthier workplace environment. MedBen WellLiving offers proven solutions to help businesses lower absenteeism and reduce long-term health care costs.

Offering employee incentives can further drive up screening numbers. In 2017, first-year MedBen WellLiving clients who offered premium-related incentives saw an average 29% increase in wellness compliance.

MedBen WellLiving can help employers defy cancer screening trends. Learn more by contacting Vice President of Sales & Marketing Brain Fargus at


  04:24:00 pm, by MedBen5   , 190 words,  
Categories: IRS, Compliance, Health savings accounts (HSAs), High-deductible health plans (HDHPs)

Check Your Compliance with HSA and HDHP Requirements

IRS Building

Health savings accounts (HSAs) are becoming more and more popular as a vehicle to empower health savings and lower premium costs, but the related regulations – particularly those pertaining to the associated high deductible health plan (HDHP) – can be confusing.

The Internal Revenue Service (IRS) applies detailed rules on the set-up and administration of HSAs. In order for the account holder to benefit from tax advantages associated with such an account, the individual must also be covered under a qualifying HDHP.

To ensure that your HSA is in compliance, we recommend that you review it against our newly revised educational summary, High Deductible Health Plan (HDHP) used with Health Savings Accounts (HSAs), which can be found at This updated summary includes information on telemedicine programs and HSAs and the 2019 IRS approved limits for qualifying high deductible health plan and HSA contributions.

As always, the MedBen Compliance Department is here to help you with the design of your HDHP. Additionally, the IRS has information regarding HSAs available on its website at If you have any questions, please contact Director of Compliance and Medical Management Erin Kelly at or (800) 423-3151, ext. 368.


  04:40:00 pm, by MedBen5   , 237 words,  
Categories: Announcements, News, MedBen Employees

MedBen Celebrates 80 Years in 2018 Client Report

2018 MedBen Client Report cover

Keep an eye on your mailbox this week, because the 2018 MedBen Client Report is on its way!

In this year's edition of our annual report, we mark a very special occasion: MedBen's 80th Anniversary. To celebrate this benchmark event, we've gone all the way back to 1938 to share archival images and advertisements from our eight decades. Of course, we also let you know what MedBen’s been doing most recently to help your business succeed. We hope you'll find it informative as well as entertaining!

If you're a MedBen client or broker, you should receive the Client Report this week (please let us know if you don't!) – and if you're not a current customer, we'd be happy to send you one. Just contact our Sales Analyst Sally Wood at (800) 423-3151, ext. 502 or with your name, company name and address, and she'll see you get a copy.

One more thing: Not to give any spoilers away, but there's a specific passage in the MedBen Client Report we'd like to highlight here, because it bears repeating:

"For those of you who have been a part of our story – be it just for a few months or for multiple decades – we sincerely appreciate your trust in us. We pledge to continue earning that trust, and hope to serve you for many years to come."

And on behalf of every MedBen employee, today and for the past 80 years, we say… thank you!

  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

  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


  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 for more information.


  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 »


  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


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 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. 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, 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 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, 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

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