The Importance of IBNR in Self-Funded and Traditional Health Plans
Understanding and accurately predicting future liabilities is crucial to the sustainability and success of insurance companies and self-insured employer-sponsored health plans. Incurred But Not Reported (IBNR) liabilities is an important concept and [...]
Inflation Reduction Act Pharmacy Provisions – Implications and Other Changes
Introduction This is the final article in a three-part series[1],[2] discussing the impact of the Inflation Reduction Act (IRA; H.R. 5376)[3] provisions. First, we’ll cover the Medicare Prescription Payment Plan (aka ‘out-of-pocket [...]
Inflation Reduction Act Pharmacy Provisions – Part D Changes
Introduction This is the second[1] in a three-part series discussing the impact of the Inflation Reduction Act (IRA; H.R. 5376)[2]provisions. Here we’ll look deeper into the changes coming to Medicare Part D, [...]
Diagnosis Co-Occurrence
Patients with multiple chronic diseases constitute a small minority of the total population but the majority of healthcare costs. These patient’s healthcare needs cannot be understood simply as the sum of each disease [...]
Understanding Provider Financial Losses in Value-Based Contracts
The shift from fee-for-service (FFS) healthcare models to value-based care (VBC) has been a monumental transformation in the healthcare industry. However, as this transition unfolds, it has added significant complexity to the healthcare [...]
Drug Price Negotiation Program
Introduction This is a follow-up to a prior Inspire Blog article[1] we posted and the first of three we’ll be posting now that more information, detail, and realities have come to pass; [...]
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