By Cynthia McGrathHealthcare Cost Trends and ChallengesSince the COVID-19 pandemic hit the United States in force in March, there’s been a dramatic impact on medical claims:Medical claims have dropped precipitously as provider groups closed or limited their practices in order to ensure capacity for coronavirus patients and patients stayed away to avoid potential exposure. Most elective procedures were canceled or postponed. Provider practices have or are in the process of reopening, but traffic is not back to usual levels;Mental health care has skyrocketed as people face increased anxiety, stress, and social isolation. Much of this care transitioned to telehealth platforms, enabling patients to receive care in the comfort and safety of their home; andPrescription drug costs have largely been unaffected – spending continues to climb.These trends factor into the five reasons why 2021 he...

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By Cynthia E. McGrathThe COVID19 crisis is hitting the higher education industry particularly hard. Four-year colleges may face a loss of up to 20 percent in fall enrollment, according to a recent survey cited in Inside Higher Ed. Carlos Santiago, the Massachusetts commissioner of higher education, says in a recent Boston Business Journal article that no event has changed the nature of the higher education sector as much as the coronavirus pandemic. He projects that enrollment-driven and tuition-dependent colleges and universities will be especially vulnerable to closing or merging with other institutions.Human Resources departments are on the frontlines of trying to bring costs under control. Furloughs, layoffs, early retirement incentives, and benefit cuts are all strategies for reducing costs. Recognizing that collaboration between colleges and universities could help HR department...

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By Cynthia McGrath, HR and Healthcare Marketing Communications ConsultantTackling rising costs and gaps in healthcare quality remains a challenge. One of the hottest trends over the last few years to address these needs – high-deductible plans and consumerism – is on the decline. A January 2020 report by Lively, a Health Savings Account (HSA) platform, found that the average American spends 96% of their HSA contribution on qualified expenses instead of saving money toward future expenses, a primary benefit of HSAs.“The concept of consumerism – having patients shop for care – hasn’t worked, and employers are moving away from these programs,” said Ellen Kelsay, Chief Strategy Officer, and Future President and CEO of the National Business Group on Health (NBGH), a coalition of large employers and industry partners, at a recent New England Employee Benefits Council event. Instead, employe...

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Here are the tasks and deadlines for joining January 1; the timeline is similar for other times of the year:Submit letter of authorization, claims data, and working rate fee by August 31Determine your plan designs by August 31Review rates, make plan design adjustments, and determine choice of carrier by September 15General Counsel executes contractual agreements by October 1Fiscal Department provides financial and banking information by October 15Open Enrollment takes place late October – early NovemberEstimated premium and stop loss invoices due for January by December 15Adjusted final enrollment premium and stop loss invoices due for January by February 1

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By Cynthia McGrath, HR and Healthcare Marketing Communications ConsultantWe use a silo approach to healthcare. A podiatrist treats your foot or ankle; a cardiologist ­ your heart; and a dermatologist ­ your skin. Primary Care Physicians do their best at coordinating all of your care. However, your mental health is often overlooked no matter which kind of physician you’re visiting. “Treating the whole person is critical for quality of life,” said Teri Weber, Senior Vice President, Spring Consulting Group. “You can’t talk about someone’s health without including behavioral health.”Patients with complex medical conditions frequently suffer from other conditions, including behavioral health issues. The 2011 SYNTHESIS initiative by the Robert Wood Johnson Foundation found that:68% of adults with mental disorders have medical conditions; and29% of adults with medical conditions have mental ...

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CINDY MCGRATH | February 4, 2019How do we go about improving care for our employees while reducing costs? That’s the conundrum facing most employer healthcare purchasers. According to HCMS Group (dba Workpartners), edHEALTH’s data warehouse, 5% of our insureds represent over 50% of our claim costs. Our Board made the strategic decision to target these high-cost claimants. We believe it will be a triple win: an opportunity to reduce costs, improve care for our members, and benefit our participating schools.edHEALTH’s premium trends have consistently been lower than the industry. Over the last four years, we’ve averaged premium increases of 2.7% per year. That’s much better than national trends of 4.1% (Kaiser Family Foundation), and even better when employer cost shifting is factored in. We have made very few benefit changes since our inception in 2013. The first step in launching our ...

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TRACY HASSETT | February 27, 2017from New England Board of Higher Education JournalWhile collaboration takes time, there is strong evidence that it is necessary for bending the rising healthcare cost trends experienced by higher education institutions. Read this 2/27/17 New England Board of Higher Education Journal article to find out the role collaboration played in addressing healthcare costs.

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TRACY HASSETT | October 31, 2016When we started edHEALTH three ago, I never imagined I’d be an employee of edHEALTH, that we’d reach so many of our goals so quickly, that we’d have a website, or that I’d be writing my first blog!If you’re reading this blog, you’re either already a member of edHEALTH, you’re an edHEALTH partner, or you’re interested in learning more about edHEALTH.  No matter what your reason is, you’ve come to the right place. For those of you who don’t know me, my name is Tracy Hassett and I am the president of edHEALTH.  I have been in this role since September 1, 2015.  Prior to this role, I was vice president of Human Resources at Worcester Polytechnic Institute .  While at WPI, I was one of a number people from several institutions who spent more than three years looking at ways to address the ever-increasing rise of healthcare costs for our institutions, our fac...

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