Phia Group

Navigating Mental Health Parity: What Self-Funded Plans Need to Know

On April 24, 2025
In 2008, under the George W. Bush administration, the Mental Health Parity and Addiction Equity Act (MHPAEA) was enacted to ensure that health insurance plans did not impose more restrictive limitations on mental health and substance use disorder (MH/SUD) benefits – assuming they were initially covered – than those imposed on medical and surgical (M/S) benefits. More specifically, health insurers were forbidden from applying limitations such as prior authorizations, unreasonably high copays, or visit restrictions to mental health/substance use disorder treatments when medical/surgical treatments did not have such imposing constraints.

A Discussion of the Executive Order to Lower Drug Prices

On April 23, 2025
The high costs associated with prescription drugs consistently provoke conversation in the self-funded healthcare industry. Not only is it an issue that most health plans encounter, but it is also a concern that trickles down to the member-level. Whether you’ve personally experienced the effects of high-cost drugs, or they have impacted a close family member, we can all empathize with the stress of having to pay for an expensive prescription.

AI to the Rescue? How Machine Learning May Revolutionize Drug Repurposing

On April 15, 2025
Without question, artificial intelligence beholds many downright frightening risks when implemented in the healthcare field. Without proper oversight, AI could have the final say in depriving a patient of a necessary procedure or steering them towards a suboptimal physician. Or the still nascent technology, if unchecked, could account for a HIPAA breach with the slapdash handling of PHI. Yet, that being said, AI is undoubtedly here to stay and as far as the healthcare industry is concerned, this technological revolution is brimming with astonishing potential, as evidenced by the recent development of AI expediting the repurposing of existing drugs for treatment of rare diseases.

Tariff Talk - How Trump’s Pharmaceutical Tariffs Could Impact You (and How You Can Prepare)

On April 11, 2025
As the self-insurance industry braces for potential changes under President Trump’s administration, one issue looms large: impending tariffs on pharmaceutical drugs. These proposed tariffs, aimed at boosting domestic manufacturing, could ripple through the healthcare ecosystem, affecting employers sponsoring self-funded health plans, third-party administrators (TPAs), stop-loss carriers, brokers, and vendors. For an industry built on balancing cost control with quality care, understanding these impacts and preparing strategically is critical. More importantly, as we navigate these changes, we must remain steadfast in our commitment to ensuring that our members get access to quality, affordable prescription drugs.

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.

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).

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.

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.

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.

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.

Care Empowered Pricing | Future of Reference-Based Pricing

On January 30, 2025
Explore the benefits of Care Empowered Pricing, delivering tailored support for TPAs and health plans to ensure high-quality care and fair pricing for members.

House Republicans Propose Changes to HSA-Qualified HDHPs

On January 24, 2025
Learn about the implications of H.R. 5688, which aims to enable individuals to contribute to HSAs while using direct primary care, benefiting those with HDHPs.

The Invisible Truth of Healthcare | Cost vs. Quality

On January 24, 2025
Explore the hidden truths of healthcare costs and quality, highlighting the disparities in pricing and the need for patients to become informed consumers.

The Phia Group's Role in Transforming Healthcare with AI

On January 13, 2025
Learn about the merger of The Phia Group & Machinify, focusing on innovative AI technology that streamlines the healthcare claims lifecycle & improves outcomes.