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The Healthcare Landscape – Part One The Pharmacy Problem: Dealing With the Dramatic Increase in Pharmacy Costs

Last month, Scott Benefit Services hosted the Business North Carolina 2017 Health Care Round Table in Greensboro.  Sean Willoughby-Ray, Benefits Practice Lead/Vice President, along three other healthcare industry professionals representing Premier Inc., The Brody School of Medicine at East Carolina University, and Blue Cross and Blue Shield of North Carolina, shared insights into the future of healthcare in North Carolina and the impact on the state’s economy.

The video below is the first in a three-part series that we will share in the coming weeks highlighting the discussions from the roundtable event.  In this video, Sean Willoughby-Ray and Mitch Perry, Senior VP and CFO of Blue Cross and Blue Shield of North Carolina, discuss some of the issues surrounding the dramatic increase in pharmacy costs, especially specialty medications.   

With pharmacy costs expected to account for up to 50% of an employer’s healthcare spend within the next five years, employers must focus on their pharmacy benefit challenges today.  Contact Scott to discover how we can help you take control of your organization’s health risks and better manage your medical and pharmacy spend.

AHCA Pulled Prior to Vote, ACA Remains

Healthcare Reform

Around 3:30 p.m. on Friday House Speaker Paul Ryan came to the conclusion that the GOP didn’t have the votes in the House of Representatives to pass the American Health Care Act (AHCA) and pulled it off the floor prior to a vote. 

This outcome came after a very tumultuous three weeks for the AHCA legislation, including multiple amendments, a CBO score that showed 24 million more people would be uninsured under the law, and what was perceived as rushed committee mark-up meetings and votes to keep the legislation moving forward.

In a prepared statement late Friday, Speaker Ryan acknowledged that the Affordable Care Act (ACA) is the “law of the land for the foreseeable future.”  Lawmakers have differing opinions as to how quickly they will resume efforts to repeal and replace the ACA, but most think it will not be an immediate priority.

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GOP Releases The American Health Care Act Proposed legislation would repeal and replace the Affordable Care Act

Last night, Republicans in the U.S. House of Representatives released their proposed repeal and replacement bill, called the American Health Care Act.  The proposed legislation is a two-part bill, one coming from the Ways and Means Committee, and the other from the Energy and Commerce Committee.

Most notable for employers, the proposed legislation repeals the employer mandate and there will be no cap on the employer tax exclusion. (A full summary of the major impacts of the bill is included at the end of this post.)

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Trump Issues ACA Executive Order

On Friday, shortly after he took the oath of office, President Trump signed an executive order designed to “minimize the economic burden of the Patient Protection and Affordable Care Act”.

While the President works with Congress to attempt to repeal and replace the ACA, this executive order allows the U.S. Department of Health and Human Services – and other departments – to delay implementing any part of the law that might place a “fiscal burden on any State or a cost, fee, tax, penalty, or regulatory burden on individuals, families, healthcare providers, health insurers, patients, recipients of healthcare services, purchasers of health insurance, or makers of medical devices, products, or medications.” 

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Top Risk Concerns for Businesses and Individuals

Business leaders and consumers share many common concerns, according to data compiled from the 2016 Travelers Risk Index. The annual survey found that cyber risk is still considered one of the greatest risks facing both Americans and American businesses. And while businesses worry more about the implications of getting hacked, consumers are primarily concerned about personal privacy loss, identity fraud and cyber threats.

Top Business Risk Concerns

Medical cost inflation, increasing employee benefit costs and cyber-related technology risks/data breaches again topped the Travelers Risk Index for business concerns in 2016, although the overall proportion who felt the business environment is becoming more risky declined slightly from 2015 to 2016, from 44 percent to 41 percent. 

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