Sam Melamed’s Post

The rising cost of health care has left families, businesses, and individuals struggling. As conversations unfold, it’s easy to feel that meaningful change is out of reach. But there’s hope. New research from Ann-Somers Hogg “Zero-inflation health care: A national strategy for unlocking and scaling insurance innovation,” reveals the root causes of our health insurance dysfunction and presents a practical, scalable roadmap to transform the insurance landscape through #businessmodelinnovation and a new value network. By addressing these foundational issues, we aim to provide tools for health care innovators and policymakers to create a system that works for everyone—and delivers better health outcomes for all Americans. This isn’t just about understanding what’s wrong; it’s about empowering those with influence to create solutions that last. Real change isn’t just feasible—it’s likely when we come together with knowledge, vision, and a commitment to act. This is also the start of a conversation to change the national landscape, and we’d love for you to join it. Read more here: https://lnkd.in/g3yTiWnm #HealthCareTransformation #HealthInsuranceReform #BusinessInnovation #HealthCareCosts

A new Paragon Health Institute paper, “It’s Not Just the Prices: ACA Plans Have Declined in Quality over the Past Decade”, reveals that, not only are federally subsidized (Obamacare) insurance plans among America’s most expensive forms of health coverage, dollar for dollar, but they are also, increasingly, the worst! 😕 Patients’ access to doctors and top-notch hospitals is shockingly low, while patient out-of-pocket exposure is extremely high ($10,000 deductibles are not uncommon). 📈The new report, while not surprising, confirms our view that “coverage does not equal care.” And it underscores the need to reform federal health programs to put consumers, rather than politicians and bureaucrats, in the driver’s seat https://lnkd.in/gXRAV94h

🩺 Delay, Deny, Defend: The Hidden Cost of Private Health Insurance When we think about health insurance, we hope for protection and peace of mind. But too often, the reality is far from it. Private health insurers have come under scrutiny for their practices, often summed up by three words: delay, deny, defend—tactics used to avoid paying claims, leaving patients to bear the brunt of the financial and emotional cost of care. 🛑 A Tragic Reminder Recently, this troubling reality came into sharp focus with the tragic death of Brian Thompson, an executive at UnitedHealthcare. The words "delay, deny, defend" were shockingly found at the scene, a chilling reminder of the impact these practices can have. ⚠️ What’s Happening? ❌ Denied Claims: Treatments like chemotherapy are deemed "non-necessary," leaving patients to fight for their lives without coverage. 🌀 Deliberate Complexity: Policies are designed with loopholes, making it nearly impossible for patients to claim what they’re entitled to. 📈 Cost Shifting: Premiums continue to rise while mental health and preventive care reimbursements are minimized or outright denied. These tactics may boost profits, but they devastate patients' health, finances, and trust in the system. 🌟 A Better Path is Possible What if health insurers took a proactive approach? Prevention, promotion, and patient empowerment could reduce claims, improve outcomes, and maintain profitability. 🌿 Prevention & Promotion: Focusing on keeping people healthy means fewer claims overall. 💻 Technology Enablement: Streamlining processes for transparency and efficiency. 🎯 Personalization & Natural Solutions: Offering tailored care that prioritizes long-term health. It’s not about sacrificing profits—it’s about finding ethical and sustainable solutions that benefit both patients and insurers. 💬 Let’s Start the Conversation This moment, sparked by tragedy and systemic challenges, is an opportunity for transformation in healthcare. Insurers like United Healthcare and others can—and should—seize this chance to innovate and improve. 💡 What do you think? Have you experienced delays or denials with health insurance claims? What solutions would you like to see? Let’s discuss how we can drive meaningful change together. 📹 Watch the video for more insights, and drop your thoughts in the comments! #HealthcareReform #Healthcare #insurance #health

I just posted about our team's work on Rx price transparency. Important work, make no mistake. But it is not the only lens through which the Health Economics team at Minnesota Department of Health look to understand trends in the health care market and monitor changes. Today a quick heads-up on our latest Health Plan Administrative Cost Report (https://lnkd.in/g-4U9XuK). What did we find? (1) In 2021, Minnesotan's paid health plans $2.32B to offer, design, sell health insurance policies through which we access health care services. That is about $419 per insured resident. (2) Trends for administrative spending are decidedly above inflation? Should that be? Why?

🗳️ How Could the Fall Election Affect Health Care Coverage? The next president has the power to either protect and build on recent gains in #healthcoverage and affordability or return to policies that led to high uninsured rates, high premiums and out-of-pocket costs, and rising medical debt. In the latest explainer in our special series What’s at Stake in the 2024 Election, we look at how this fall’s election could affect people’s health insurance coverage. 🔵 A Harris administration would likely continue efforts to reduce health plan premiums and expand coverage while protecting consumers from #medicaldebt. 🔴 A second Trump administration would likely loosen market regulations and try to reduce federal health spending in ways that could make it more difficult for people to afford coverage. Learn how each candidate might approach coverage expansion, out-of-pocket costs, medical debt, and #healthcare affordability.

Tick-tock ⏰ — we're now within 90 days of January 1st, 2025! If rising healthcare costs aren't keeping you up at night, feel free to hit snooze on that alarm clock. But if you're wide awake (and a little worried), the time to act is NOW. Why sleepwalk through another renewal when benefEx benefit consulting and Mitigate Partners can offer real solutions with actual claims visibility? Contact us today and let’s make sure your health plan works harder for you and your employees — and not just for insurers' shareholders. #HealthCareThatWorks #TimeToAct #EmployeeBenefits #PriceTransparency"

Q4 starts next week. For most - that means group health insurance enrollment. Question - are you prepared for cost increases? Some projections show increases as high as 11%. Question - what steps are you taking to consider other plans? Or are you simply renewing? Question - do you have visibility into your group's actual claims history? It's federal law that YOU have to attest that your plan does not have limitations on requesting or being provided actual health cost data from your insurer. If you're not concerned - then carry on and pay more. If you are concerned, then contact us. We can help. Our clients enjoy Healthcare that Works. Visit mitigatepartners.com to learn more. #hropportunities #pricetransparency #healthcarecosts #employeebenefits #ceo #cfo #cfoforum #ceoforum #mitigatepartners https://zurl.co/RZ3e

FINANCIAL HEALTH AND MEN'S HEALTH The financial cost of poor health! How health issues can impact financial stability and the importance of health insurance. THE FINANCIAL COST OF POOR HEALTH:⬇️ • Unexpected Medical Expenses: Potential unexpected medical costs due to accidents, illnesses, or chronic conditions. • Lost Wages: Time off work due to illness or injury can significantly impact your income. • Reduced Productivity: Poor health can lead to decreased productivity and job performance, affecting both individual and company earnings. • Long-Term Care Costs: As people age, the risk of needing long-term care increases, which can be a significant financial burden. THE IMPORTANCE OF HEALTH INSURANCE:⬇️ • Comprehensive Coverage: Benefits of having comprehensive health insurance that covers a wide range of medical services. • Financial Protection: Health insurance can protect individuals and families from the financial consequences of unexpected medical expenses. • Preventive Care: Importance of preventive care, such as regular check-ups and screenings, which can be covered by health insurance. SUCCESS BROKERS | MEDICAL AID Choosing a medical aid can be quite confusing and stressful that’s why we here to assist you and guide you through the process. Our industry leading medical aid CRM System allows you to compare various different plans in a simple and effective manner and this will enable you to make an informed decision. We have partnered with various medical aid providers to ensure that we able to offer you the very best solutions in terms of both cover and affordability.🙌🏻 PRIORITIZE YOUR HEALTH AND FINANCIAL WELL-BEING, GIVE US A CALL TODAY!📞 Authorised Financial Services Provider No. 14400 [Visit our website:]🔗 https://lnkd.in/dX3X5Yq 📨[email protected] 📲Tel: (011) 449 4444 #SuccessBrokers #InsuranceWithAssurance #FinancialHealthAndMensHealth #FinancialCostOfPoorHealth #HealthManagement #MedicalAid #GapCover #HereToAssistYou #PrioritizeYourHealth #BestSolutions #CoverAndAffordablePlans #ImportanceOfHealthInsurance #MensHealthAwarenessMonth #WeCare

“The medical bill debt just kept coming, it was like a train wreck I didn’t know how to stop” Stories like these are heartbreaking yet it’s a reality for many employees. Health insurance can be great as a cushion but without healthcare navigation employees often unknowingly pick hospitals with overpriced procedures and lead to situations like these. On top of that without having steerage programs like The Healthcare Navigator, employees aren’t able to find their medications, labs or mental healthcare at affordable prices. This drives up the costs for the employee and the claims for the employer. Luckily employers everywhere are waking up to this sobering truth and are saying ‘enough is enough’. Protect your employees and your bottom line with The Healthcare Navigator. https://lnkd.in/gs-ntwM3 https://lnkd.in/gduSf6yS

Rising health care costs are creating real challenges for many of the nearly 40 million midlife adults with employer-sponsored insurance, as detailed in a new post from the AARP Public Policy Institute. Policymakers and employers should recognize that these rising costs impact the affordability of, and access to, health care for this group of workers (ages 50-64) and find ways to ensure they can maintain affordable health coverage and access the care they need. #Affordability #HealthInsurance https://lnkd.in/eCAnnNHX