Phia Group

Care Empowered Pricing as a Money Saver

On April 10, 2025
For over a quarter century, The Phia Group has championed a broad spectrum of cost containment initiatives to empower health plans and ultimately, their respective participants. The Phia Group believes that its latest endeavor—Care Empowered Pricing (CEP)—may be its most robust cost containment program yet. At its core, CEP is engineered to, quite simply, save plans money and as you can see below, there are a number of ways our revolutionary offering does so.

Proceed with Caution: A.I. Has Forever Changed Healthcare – but at What Cost?

On April 10, 2025
Steven Spielberg’s 2001 summer blockbuster A.I. Artificial Intelligence may not have been the director’s most highly acclaimed film, but it may very well have been his most prescient work. Here we are, nearly a quarter century later, and A.I. continues to be all the rage in nearly every facet of society, including, yes, healthcare. The potential breakthroughs for enhancing patient outcomes are breathtaking, truly resembling features of a sci-fi flick. However, as we’ve painfully realized over the past couple years, the robots can’t be trusted to do everything – especially when patients’ information (and lives?) are at risk. Indeed, there continue to be considerable ethical concerns such as algorithmic bias and data privacy violations when A.I. meets healthcare. Undoubtedly, A.I.’s influence on healthcare is a loaded, multifaceted topic.

Empowering Plans: P215 – Plan Sponsor Discretion Advised

On April 8, 2025
ERISA gives plan sponsors great power and great responsibility. On this week’s podcast, attorneys Ron Peck and Nick Bonds get back to ERISA fundamentals to talk about how to really embrace fiduciary status and properly exercise discretionary authority.

Overhauling HHS – Can a Leaner, Meaner HHS Make America Healthy Again?

On April 7, 2025
The second Trump administration has not been shy about taking steps to shake up U.S. health policy. There has been a flurry of executive orders on a range of healthcare topics, including stepping up enforcement of price transparency rules; a push to expand coverage for and lower the out-of-pocket costs for in vitro fertilization; and taking steps to redefine sex-based discrimination in federal policy and to discourage treatments for gender dysphoria. Even so, the executive action poised to have the broadest impact on health policy may just be the sweeping changes being made to the Department of Health and Human Services (HHS).

Empowering Plans: P214 – Unpacking Weight Loss Drugs

On March 28, 2025
On this episode of the Empowering Plans podcast, attorneys Corey Crigger and Kendall Jackson discuss the hot button topic of weight loss drugs. Tune in to learn more about the latest advances in this space and the various coverage and exclusion options plans may pursue.

The Social Impact of Mental Health Parity Testing Explained

On March 24, 2025
Explore the social impact of mental health parity testing, including its effects on access to care, stigma reduction, and the importance of equitable treatment.

Pancreatic Cancer Vaccine | A New Hope on the Horizon

On March 17, 2025
Learn about the promising new pancreatic cancer vaccine, Lenmeldy, & its potential to revolutionize treatment for this disease & improve patient outcomes.

Empowering Plans: P213 – Error 304: Good Faith Negotiation Not Found

On March 13, 2025
Artificial intelligence may be changing the trajectory of the self-funded industry – but can it negotiate? In this episode of The Phia Group’s Empowering Plans podcast, attorneys Brian O’Hara and Jon Jablon break down real-life examples of AI-driven responses in the No Surprises Act’s Open Negotiations process that range from nonsensical to outright misleading, where negotiating with AI is like trying to haggle with a toaster. From missing claim numbers to automated counteroffers that make no sense, Brian and Jon discuss whether AI is making negotiations easier, or defeating the purpose of the statutory process to begin with. Tune in for an honest discussion of the pitfalls of AI in No Surprises Act negotiations.

RBP vs. PPO Plans | Understanding the Key Differences

On February 27, 2025
Explore the differences between Reference-Based Pricing (RBP) and PPO plans, including their benefits, drawbacks, and implications for healthcare costs.

Empowering Plans: P212 – Lewandowski v. Johnson & Johnson – Big win or warning?

On February 27, 2025
On this episode of the Empowering Plans Podcast, attorneys Brady Bizzaro and Cindy Merrell delve into the details of the Lewandowski v. Johnson & Johnson case. Is this case a big win for plan fiduciaries or a warning?

Struggling to Breathe | The Global Medical Oxygen Crisis

On February 26, 2025
Explore the global crisis of medical oxygen access, highlighting disparities in availability in low-income countries & its impact on patient care.

Empowering Plans: P211 – Network Adequacy Under MHPAEA

On February 13, 2025
Attorneys Kelly Dempsey and Bryan Dunton dive into the results of the 2024 MHPAEA Report to Congress. The EBSA and CMS have continued to improve their focus on network design and adequacy for group health plans. In this episode, Kelly and Bryan discuss how these parity problems manifest themselves in testing and what plans can do to resolve them.

The Future of Healthcare Under Trump 2.0

On February 12, 2025
Like every other industry in America right now, healthcare is at a flash point. Amidst President Donald Trump’s flurry of executive orders, everyone from healthcare executives to patients is trying to anticipate what the future holds. What will happen to directives by former President Joe Biden that reduced drug costs and broadened coverage under the Affordable Care Act and Medicaid? What’s the future of gender-affirming healthcare for transgender people under the new look HHS? Will the number of uninsured Americans spike in the coming months? What’s the latest on proposed new cybersecurity requirements for HIPAA? Naturally, such questions – and so many more – have surfaced in the wake of a tidal wave of sweeping executive orders. The Phia Group’s panel of experts provides insight into topics that matter greatly to you.

Journavx | A New Non-Opioid Solution for Pain Management

On February 11, 2025
Learn about Journavx, a groundbreaking non-opioid analgesic designed to treat acute pain, & its implications for patients seeking safer pain management options.

The Phia Group Celebrates 25 Years of Innovation, Perseverance, and Industry Leadership

On February 10, 2025
Twenty-five years ago, The Phia Group was nothing more than a dream. No outside investors, no loans, no safety net—just $8,000, donated hand-me-down furniture and computer equipment from friends and family, and an unwavering belief that there was a better way to serve the self-funded healthcare industry. In fact, the first Phia System was built by us and family members on nights and weekends. It’s in our core - it’s what guides us every day.