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This room contains pieces drawn from my experiences at Health Decisions. It offers practical advice for anyone involved in managing group health plan expenses.
From the present, this room contains articles and reports by others that I wanted to share. Reasons for sharing will vary, so expect a potpourri.
This room provides reference points and norms I have observed or documented that can be used by persons trying to get their bearings in the often confusing world of group health.
This room contains my views on the future of the US health care system. My intent is not to convince anyone, but to broaden the discussion beyond the political debate that passes for health reform in America.
This room contains recordings and trasncripts of conversations I've had with interesting people I have had the privilege of meeting. Some are friends, some professional acquantances; all have interesting perspectives worth sharing.
From the past, this room contains some of the talks and articles I have done that I thought were worth sharing.

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Statement on Fiduciary Responsibilities 

Wednesday, June 13, 2012 1:20:00 PM Categories: Tools of the Trade
Statement on Fiduciary Responsibilities There are many positive reasons for conducting claim and enrollment audits with Health Decisions. Typically, the opportunity for economic return through recoveries receives the most attention. However,... read more
 
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The Five Levers of Management Control for Your Health Plan 

Thursday, May 31, 2012 1:29:00 PM Categories: Prior Presentations

As every employer knows, health plan costs are one of their largest and fastest growing expenses. Like any business expense, health plan costs must be managed strategically and proactively. This webinar is for employers and their health plan fiduciaries, executives, managers, administrators, and their advisory teams. The presentation is structured around the "Five Levers of Management Control" that encompass all the health plan management options available to employers.

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Listen to the Doctors: How the AMA is Helping Plan Oversight  

Tuesday, May 1, 2012 3:11:00 PM Categories: Prior Presentations
Each year the AMA (American Medical Association) publishes a National Health Insurer Report Card. The AMA Report Card compares the administrative performance of seven major insurers and Medicare across seventeen metrics. More importantly,... read more
 
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Health Data: Plan Control Starts Here 

Friday, March 30, 2012 3:28:00 PM Categories: Prior Presentations
The party that controls plan data controls the plan. This simple truth is often overlooked by self-funded plan fiduciaries and advisors. Data is often seen as a hassle or too technical for some. HIPAA concerns, often exaggerated, further... read more
 
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Health Reform: A Contrarian’s Perspective 

Tuesday, February 28, 2012 1:14:00 PM Categories: Prior Presentations
Health reform in America has little to do with the Affordable Care Act (AKA “ObamaCare”). This effort, like so many before it, will leave behind layers of new rules and regulations. But true health reform will continue in spite of and not because ... read more
 
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The Road to 100% Transparency 

Tuesday, January 24, 2012 3:35:00 PM Categories: Prior Presentations
Transparency means being able to see what is going on. How transparent is your self-funded health plan? Most plans have either never asked this question or never gotten a complete answer. In January 2012, Si Nahra, President of Health... read more
 
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2012: What Does it Hold for Self-Funded Health Plans?  

Tuesday, December 20, 2011 12:10:00 PM Categories: Prior Presentations
In 2012, the US Supreme Court will give Obama’s health reform a “thumbs up or thumbs down.” What will that mean for self-funded plans? What will change? What will stay the same? These and other questions will be explored in this... read more
 
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Collecting Claim Overpayments 

Tuesday, November 29, 2011 12:22:00 PM Categories: Prior Presentations
Finding claim overpayments is easy. Collecting them is not. Claim audits routinely find 5% to 10% in overpayments. But collection efforts typically yield 1% to 3%. Why does this happen? What can be done to improve overpayment collection ... read more
 
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Overpayment Collection 

Sunday, November 27, 2011 12:02:00 PM Categories: Prior Presentations
Finding claim overpayments is easy. Collecting them is not. Claim audits routinely find 5% to 10% in overpayments. But collection efforts typically yield 1% to 3%. Why does this happen? What can be done to improve overpayment collection ... read more
 
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Finding Provider Fraud 

Thursday, October 27, 2011 2:14:00 PM Categories: Prior Presentations
Fraud prevention starts with fraud detection. This webinar features two innovators in fraud detection. Rich Lanza is a nationally recognized Certified Fraud Examiner who has developed principles and procedures related to fraud... read more
 
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