Forbes on Nostr: More Risks, More Opportunities: What’s Next For Employers In Healthcare? ========== ...
More Risks, More Opportunities: What’s Next For Employers In Healthcare?
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Employer-sponsored health insurance covers a significant portion of the U.S. population. Two recent class action lawsuits have made employers nervous about their management of health benefits. The lawsuits cited the breaching of fiduciary duties under the Employee Retirement Income Security Act of 1974 (ERISA). More lawsuits are expected to emerge applying ERISA to employers' management of health benefits. The Consolidated Appropriation Act of 2021 provides even more channels for litigation against employers for breaching fiduciary duties under ERISA. The legal risks are forcing employers to reconsider their hands-off approach to purchasing healthcare and consider direct contracting with providers. Cash prices are often lower than insurer negotiated prices. Large employers like Walmart and Amazon are directly contracting with hospitals and health systems. Price transparency legislation and policy changes are needed to facilitate employer-provider direct contracting and stimulate price competition. Innovative efforts from employers and legislative actions are needed to fulfill employers' fiduciary duties and mitigate litigation risks.
#Healthcare #Employers #HealthInsurance #FiduciaryDuties #DirectContracting #PriceTransparency
https://www.forbes.com/sites/gebai/2024/04/07/more-risks-more-opportunities-whats-next-for-employers-in-healthcare/
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Employer-sponsored health insurance covers a significant portion of the U.S. population. Two recent class action lawsuits have made employers nervous about their management of health benefits. The lawsuits cited the breaching of fiduciary duties under the Employee Retirement Income Security Act of 1974 (ERISA). More lawsuits are expected to emerge applying ERISA to employers' management of health benefits. The Consolidated Appropriation Act of 2021 provides even more channels for litigation against employers for breaching fiduciary duties under ERISA. The legal risks are forcing employers to reconsider their hands-off approach to purchasing healthcare and consider direct contracting with providers. Cash prices are often lower than insurer negotiated prices. Large employers like Walmart and Amazon are directly contracting with hospitals and health systems. Price transparency legislation and policy changes are needed to facilitate employer-provider direct contracting and stimulate price competition. Innovative efforts from employers and legislative actions are needed to fulfill employers' fiduciary duties and mitigate litigation risks.
#Healthcare #Employers #HealthInsurance #FiduciaryDuties #DirectContracting #PriceTransparency
https://www.forbes.com/sites/gebai/2024/04/07/more-risks-more-opportunities-whats-next-for-employers-in-healthcare/