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HealthSmart Blog

As the cost of health benefits continues to rise faster than the rate of inflation, many plan sponsors are looking for alternatives to traditional PPO networks. Plan sponsors want benefits administration partners that can deliver creative and comprehensive solutions that control costs while delivering high quality clinical outcomes and member satisfaction. SmartDecision, HealthSmart’s approach to Reference Based Pricing (RBP), offers a unique alternative.

Diabetes is a costly, chronic disease that is widespread and becoming more common. Most cases arise from poor diet and other behavioral contributing factors. The good news is that prevention starts with awareness. World Diabetes Day is November 14, 2020. HealthSmart recognizes this important day with resources to help members manage this disease. Learn more!

The rising cost of care is a major issue for all types of payers, but a single case of a rare or complex condition can wreak havoc on a self-funded plan. Join HealthSmart for an informative webinar explaining how our data-driven clinical approach to specialty case management can protect your clients from catastrophic losses. Pam Coffey, RN, Chief Clinical Officer and Martino Luu, EVP of HealthSmartRx, will share the benefits of a truly innovative approach to managing high cost clinical conditions to achieve better outcomes, reduced cost and more satisfied members and clients. Read more>>

Watch the recording


Another Medical Bill? Surprise!

3/24/2020 10:03:58 AM

If you’ve ever been to the emergency room or had a surgery, you likely know that the bill you get from the hospital isn’t the only bill you’re going to receive. Soon, you may receive a bill from the doctor (or doctors) you saw. What happens if one or more of these providers are not in your network? Now you know what surprise billing is. Read More>>

We want to assure our broker partners, clients and members that we are committed and prepared to support those we serve throughout the COVID-19 situation. As part of this commitment, we are sharing information about COVID-19, details about member access to medical care, and insight into our business continuity planning. Read more>>

Healthcare news these days frequently features articles or a quote from an industry “expert” relating to drug costs. They emphatically declare that pharmaceutical costs in general are spiraling out of control. But is this really the case? Martino Luu, EVP and General Manager of HealthSmartRx, says this may not necessarily be accurate. Read more>>

There was quite a stir in the healthcare industry – and to our clients – when HHS released a proposed rule aimed at eliminating rebates from pharmaceutical companies to PBMs in Medicare Part D and in Medicaid managed care organizations. Will manufacturers unilaterally lower the list prices? What’s the impact on premiums? More>>

Recent legislative events are taking aim at price transparency, including an executive order by President Trump on healthcare price transparency. Read our guest blog by our partners, Healthcare Bluebook, for their take on the recent healthcare price transparency regulatory action.

What happens when an employee receives a bad call about their health? If they find out they have a serious – even catastrophic – health condition, how does an employer with a self-funded plan manage this?

With the anticipated growth of healthcare costs and the high costs paid to hospitals by health plans, it becomes a real challenge to “bend” healthcare costs downward.