Forum Friends, I hope you are enjoying the final days of Summer. I am excited to see everyone in person at our upcoming All-Stakeholder Meeting on September 15th. In this newsletter, learn about Sage Transparency and how stakeholders are using price, quality, and cost transparency to align payment with value; healthcare policies; and articles I thought you may find of interest.
Best,
Gloria Sachdev
President and CEO, Employers’ Forum of Indiana
Please join us in welcoming our newest Forum members…Physician’s Plan of Northern Indiana and Gibson. Learn more about each organization by clicking on their logo.
Inside the Forum
EFI All-Stakeholder Meeting on September 15th
We’re excited for our first in-person All-Stakeholder meeting in over two years! During the meeting, we will begin with a networking lunch, then take a deep dive into Sage Transparency as well as the web-based National Academy for State Health Policy’s Hospital Cost Tool.
Date: September 15, 2022
Time: 11:30am – 2:30pm ET
Location: Indiana Landmarks Center, 1201 Central Ave, Indianapolis, IN 46202
Calendar invitations were sent to Forum Members in August. If you didn’t receive one, contact sara@employersforumindiana.org.
More than 10,000 active sessions since launch!
Forum invited to present Sage Transparency to more than 15 organizations across the U.S.
More data is coming soon!
Sage Transparency, our newly developed web-based tool that compares price, quality, and cost data for over 4,000 hospitals across the country has been a massive success. We continue to receive amazing feedback about how it is being used across the United States:
- Hospital Consolidation: A Fight Worth Having (Arnold Ventures)
- Employers Are Sharing Health Price Data, but Real Change Is Slow (Bloomberg Law)
- New Study on Hospital Pricing by Houston Business Group Highlights Gaps Between Medicare and Private Insurance Payments (Dark Daily)
- Employer- and Worker-Led Efforts To Lower Health Insurance Costs (CAP)
- Gloria Sachdev talks hospital price transparency at annual Healthcare Economics Summit (Concordia University)
- New Transparency Trends: 3 Healthcare Problems (And Their Solutions) (The Alliance)
Since its launch, Gloria Sachdev was invited to present Sage Transparency to the following organizations:
- The Alliance
- Healthcare Purchaser Alliance of Maine
- Indianapolis Chamber of Commerce-Health Policy Council
- Integrative Care Partners and Gibson Conference
- National Alliance of Healthcare Purchaser Coalitions
- Kansas Business Group on Health
- Council of Insurance Agents and Brokers
- Benefit Advisors Network Annual Conference
- Physicians Health Plan of Northern Indiana
- Concordia University – Healthcare Economics Summit
- Indiana Manufacturers Association
- Medical World News
Policy Updates
Anthem Indiana Public Forum Meeting
Anthem is hosting its annual Indiana Public Forum on August 31, 2022, at 4:05 pm EST to present information in regard to 2021 premium changes, financial performance, and cost of care initiatives. Participants will have an opportunity to seek feedback either by pre-submitting questions to events@anthem.com or by asking questions during the meeting through the online chat feature. Review the full meeting details.
No Surprises Act
Map: No Surprises Act Enforcement (The Commonwealth Fund)
This interactive map summarizes the roles of the federal and state governments on various aspects of the No Surprises Act, including enforcement, specified state laws for payment determination, the use of external review for surprise-billing cases, and the patient-provider dispute resolution process. Check it out.
Court Upholds No Surprises Act as Constitutional (Health Affairs)
On August 10, 2022, a federal district court upheld the No Surprises Act (NSA) against a challenge brought by a New York surgeon who argued that major parts of the law were unconstitutional. Read the full story.
Federal Officials Revise Approach To Arbitration Under No Surprises Act (Health Affairs)
On August 19, 2022, the Departments of Health and Human Services (HHS), Labor, and the Treasury issued a new final rule to further implement the independent dispute resolution (IDR) process under the No Surprises Act (NSA). The final rule was accompanied by a press release, fact sheet, and a status update on the IDR process. Read the full story.
Health Policy in Transit – Surprise Billing Final Regulations (NAHPC/Employers’ Forum of Indiana)
The Coalition Against Surprise Medical Billing (CASMB), of which the National Alliance is a member, issued a statement following the publication of the rules. Review the summary and statement.
Inflation Reduction Act of 2022
Prescription Drug Provisions in the Inflation Reduction Act of 2022 (NAHPC)
On August 16, 2022, President Biden signed into law the Inflation Reduction Act of 2022. This expansive legislation covers prescription drug provisions, including Medicare negotiating drug prices. Read the summary from NAHPC.
Inflation Reduction Act’s Health Care Provisions Could Affect Employers (SHRM)
The climate spending and tax legislation President Joe Biden signed into law on Aug. 16 contains provisions that could affect employers that sponsor group health plans. Also, the legislation’s increase in IRS auditors could impact employer-sponsored retirement plans. Read the full story.
Indiana Passes Near-Total Abortion Ban (Ice Miller)
Read the full summary from Ice Miller.
Hear what Indiana citizens, employers, and physicians are saying:
- Eli Lilly, Cummins Speak Out Against Indiana’s Ban on Most Abortions (WSJ)
- ‘A slap in the face’: Some upset Lilly, Cummins wait to criticize abortion ban until Holcomb signed it (Indy Star)
- Their mentor was attacked. Now young OB-GYNs may leave Indiana (NPR)
- Lawmakers, leaders, companies react to new Indiana abortion restrictions law (WRTV)
Forum Member Spotlight
The Alliance
The Alliance serves as the voice of self-funded employers who want more control over their health care costs, and who believe
that affordable, high-quality care should be accessible to everyone. Every employer is different, which is why we’ve partnered with 34,000 doctors and health care providers across the Midwest to help our 300 clients create custom Smarter Networks that drive value and health benefit plans that satisfy their unique needs.
In the News
EFI in the News
- Employer- and Worker-Led Efforts To Lower Health Insurance Costs (Center for American Progress)
- How an Indiana pharmacist is teaming up with employers to fight the hidden hospital prices that drive up health care costs (Fortune)
…..find more articles in the News section of the Forum website.
COVID-19
- CDC Recommends Novavax COVID-19 Vaccine for Adolescents (CDC)
- Biden administration to stop sending free at-home COVID tests Friday (NBC News)
Employers and Insurers
- The Value of Biosimilars: Improving Treatment Access and Lowering Costs (NAHPC)
- What’s Wrong With Health Insurance? Deductibles Are Ridiculous, for Starters. (NY Times)
- JPMorgan’s Latest Health-Care Deal Aims to Cut Workers’ Expenses (Bloomberg)
- Value-based payment has produced little value. It needs a time-out (STAT News)
- Major payers including Aetna, UHC sign on to California primary care initiative (Fierce Healthcare)
Hospitals
- Ascension’s much-touted micro-hospitals fade away in Indy area (IBJ)
- Northern West Virginia hospital settles with feds for $1.5M (AP News)
- Big Hospitals Provide Skimpy Charity Care—Despite Billions in Tax Breaks (WSJ)
- IndyStar sues 8 hospitals for obscuring public spending data on nursing homes (WSJ)
Pharmacy
- How companies are shaking up how we pay for old drugs (Axios)
- Big Pharma Went All In to Kill Drug Pricing Negotiations (KHN)
- FDA Finalizes Historic Rule Enabling Access to Over-the-Counter Hearing Aids for Millions of Americans (FDA)
Physicians
- More physicians seek unions amid changing landscape, COVID-19 (Modern Healthcare)
Public Health
- Child and Teen Firearm Mortality in the U.S. and Peer Countries (KFF)
- Hospitals and for-profit PBMs are diverting billions in 340B savings from patients in need (STAT News)
- Patients With Epilepsy Navigate Murky Unregulated CBD Industry (KHN)
- Hospices Have Become Big Business for Private Equity Firms, Raising Concerns About End-of-Life Care (KHN)
Press Release: Indiana Governor’s Public Health Commission Releases Recommendations (GPHC)
Indiana GPHC report shows that we have a long way to go!
Do you have a suggestion or contribution for our next newsletter? Contact us.