Phia Group Media


Phia Group Media

Resolution to Become an Educated Consumer of Healthcare

On January 14, 2021

By: Bryan M. Dunton

Many people use the beginning of a new year as a reason to better themselves physically and emotionally, often setting goals for themselves in the process. After the pandemic of 2020 altering everyone’s plans, there’s sure to be a renewed dedication to personal goals this year. When deciding what types of personal goals to accomplish, it is important to ask yourself why these specific things are so important to you. Why do you want this change? How will it help you emotionally or physically? What’s stopping you from achieving it and how can you move beyond those obstacles?

Year after year, one of the most prominent goals is to be healthier. Two Years Ago, for example, 28% of people resolved to lose weight, 54% wanted to eat healthier, and 59% wanted to exercise more. Certainly, these are great goals to set for yourself, especially in the wake of 2020, when many people were locked down in their homes for extended periods of time and many of our favorite activities were closed. Some employers have taken a very proactive approach in encouraging their employees to be active despite the conditions created by the pandemic. Over the summer and early fall of 2020, Phia Group employees participated in a three-month long virtual race from our Canton, MA headquarters to Progressive Field (CEO Adam Russo is a huge Cleveland sports fan) as a way to get teammates moving and have some cross-department fun while many worked remotely.

Employers can make a positive difference in the health and wellness of their employees by providing the tools to become educated consumers of healthcare. Here at the Phia Group, we encourage employees to be healthy and provide them with the information and tools to do so. This includes both mental wellness as well as physical health through services such as direct primary care. We believe in educating employees about being proactive in self-care and how it factors into cost-containment for their own health expenses and that of the health plan itself. Phia often holds informational meetings for employees to discuss existing and new services being offered to maximize our opportunities for quality care at an affordable price. We have found that providing that targeted education and promoting the atmosphere of being consumers of healthcare, has led to significant cost savings for the plan.

While resolving to lose weight, eat healthier, and exercise more are important goals in the effort to having a healthy new year, we should also resolve to be educated about out health and healthcare and in so doing become consumers in the healthcare industry.

As always, we are happy to discuss these and the multiple other programs we use to contain costs with any employer who seeks to introduce similar methods to their health plans.

With an eye towards the new year, there is a strong desire for most of us that it will be different than how 2020 turned out. We hope that you take time to set some achievable goals for your own personal health and self-care this year. Here’s to 2021!

COVID-19… And What it Means to Work From Home with Small Children

On April 13, 2020

By: Jen McCormick, Esq.

COVID-19 has impacted most aspects of our lives, and the lives of our families.  From a healthcare perspective, we want to do all we can to protect our families from the virus.  In most cases this means that households where both parents work outside the home and children attend school or daycare are now all confined to their homes… every day. We do this in hopes of keeping the children and ourselves safe.  Being confined to our homes, however, can be challenging in many ways.

For families where being home is the exception over the rule this has been an adjustment.  We are forced to redefine our roles as co-workers, parents, and spouses to find the perfect work-home balance, all while at home.  Dealing with this new normal is hard, and certainly pays a toll on our mental health. Mindful of this extra stress for many, plans and employers should consider additional ways to help.

Consider ways the parent can use their health plan, for example, does the employer health plan cover telehealth? Is this available for mental health as well?  The option to contact a doctor over the phone would make receiving care easier for many. A waiver of the copay or deductible would make this even more attractive, and likely provide many benefits for the individual, their family, and work productivity.

Another consideration would be how employers are actively trying to stay engaged by using video chat features, hosting virtual happy hours, or playing virtual games.  By setting up meetups it’s a way to remain connected while still maintaining distance. No effort is unnoticed in this particularly challenging time and even a ‘how are you doing’ could make a big difference for a struggling parent.

Trump’s Healthcare Bill Failed… Here’s Why

On April 3, 2017

By: Adam Russo, Esq.

The fact that Trump’s healthcare bill failed is big news and now everyone in Washington and in the media is trying to place blame on someone, whether it’s president Trump, Speaker Ryan, the Freedom Caucus or the Democrats. The reality is that this bill would not have worked and I believe that no bill passed in the next few years will work either and the reason is simple. Neither the Democrats nor the Republicans are willing to truly lower the overall cost of healthcare.  The only way that we can have a successful health plan for all Americans is by fighting the root of the problem – the ridiculously high priced hospital and other facility bills and the huge sticker prices on specialty drugs.

There is an easy solution – force the hospitals to justify their charges and negotiate with the pharmaceutical companies on what they can charge. However, the politicians in Washington will never do it because these two entities are the reason they are in DC in the first place. They fund the campaigns, they feed the lobbyists, they are the biggest employers in most representatives’ districts.  They will never push them or fight them or even question them because they need them. If you are a politician and the largest employer in your district that employs the most people is the hospital, then are you really going to criticize their practices? Hell, no! Until this changes, we will see the same games being played as they are now. That’s why we are here at The Phia Group, because we are not afraid to criticize, to fight, to question and to ensure that our clients can offer their employees the best health care coverage at the lowest prices possible.

Concerns about Health Care Coverage Mandates

On January 27, 2017
By: Brady Bizarro, Esq.

One of the biggest unknowns of the Trump Administration’s health policy priorities is whether or not the new administration plans to repeal the individual and employer mandate. The White House has already directed federal agencies to “ease the burden” of ACA regulations on employers. Ditching the employer mandate would significantly change the landscape of employer-provided insurance, and it is something we will be watching closely.

Egregious Billing Hits the Common Man – Who Now Has a Place to Vent Their Frustration

On January 26, 2017
By: Garrick Hunt

For those of us who are embedded in the health care industry, we know that the greatest issue with health care in America is the price tag. For the average American, health care is all about “what’s my out-of-pocket going to be?” Just recently a friend of mine, an average America to be sure, took to social media and went on a tangent about their bill. He was completely dumbfounded as he read through each line item…I laughed a little, unfortunately, this is the state of the industry.

The Big Elephant in the Room….

On January 26, 2017

By: Michael Branco

From day one, over 16 years ago, we have offered overpayment recovery services, but over the last year, I have seen the largest growth in this service. It’s not enough to simply make a call or send a letter, and it’s okay to have that uncomfortable conversation with your client on why an overpayment occurred.  Ignoring the issue is no longer an option.

Want to improve health care? Focus on hospitals

On January 25, 2017
By Rich Lesser & Barry Rosenberg

(CNN) As Congress and the Trump administration debate the future of America’s health care system, they should go beyond the issues of access and cost and recognize an equally important priority: that patients come first, so health reform should also focus on quality of care.

Read more…

The ACA, a New Congress, and President Trump – Oh My….

On January 24, 2017
By Tim Callender, Esq.

On Friday January 20th, President Donald Trump signed his first executive order, directing agencies to give more leeway to the states in the way that states implement (“carry out”) the Affordable Care Act.  It appears that this executive order is primarily a precursor of things to come and is an attempt to set general expectations as to healthcare policy under the Trump Administration.  At its core, the order provides a sweeping mandate, directed at the heads of agencies that administer the ACA, to find ways to ease the financial burden of the ACA.  Specifically, the order does mention the Department of Health and Human Services, soon to be headed up by Representative Tom Price.  As all of us in the industry know, HHS might be the federal agency most impacted by the ACA.  HHS’s actions, or inactions, under this order will likely guide the IRS and the DOL, the other two federal agencies primarily guiding the day-to-day execution of the ACA.

Many pundits have already spoken up, concerned, or pleased, that this marks the end of the individual marketplace (aka The Exchanges).  Truth be told, whether a support of the ACA and its marketplaces, or not, it seems that all would agree the marketplaces have seen significant troubles and the sustainability of the model has been in question for some time.  Is this the piece that truly spells the end of the ACA marketplaces?  Perhaps it is.

But, as in all things coming from Washington D.C., we will have to wait to see the true, logistical impact of this broad, executive order.

In addition, GOP Senators Bill Cassidy (R-LA) and Susan Collins (R-ME) recently released one Republican-led proposal that may be introduced as a replacement to the ACA.  Among the highlights of the plan are measures allowing states to continue with the ACA, should they “like it” – whatever that means.  Additionally, the proposal appears to urge pricing transparency on medical procedures, while also allowing for the existing subsidies and tax credits provided in the 2010 law to remain intact.  This proposal seems to be a mid-ground departure from many other GOP plans, in that it seems to allow for many aspects of the ACA to remain in place.

The most interesting aspect of the Cassidy-Collins proposal is an item that would appear to push all uninsured residents into a federally subsidized catastrophic plan, through auto-enrollment.  Good idea or bad idea – I don’t know.  But, it feels like an interesting departure from the typical, market-driven, free-choice arguments that conservative lawmakers usually provide when discussing healthcare.  Then again, perhaps the focus on a catastrophic plan narrows the concern that this “forced” auto-enrollment would be replacing market-driven free-choice in that a catastrophic plan would not cover many of the day-to-day health needs that a plan member might want, thus pushing him or her to explore additional, private options for their routine coverage.  Perhaps the genius of this “forced” catastrophic move is that it takes a good deal of the risk off of the primary insurer thus causing those costs to decline?

It all remains to be seen.  Stay tuned as we watch, digest, and continue to comment on the upcoming changes affecting our industry.

Why Trump’s Obamacare Promise Will Be So Hard to Keep

On January 16, 2017
By Margot Sanger-Katz

As a candidate back in July 2015, Donald J. Trump promised that he would repeal Obamacare and replace it with “something terrific.”

The Senate voted, 51 to 48, on Thursday morning for a measure setting Congress on the path toward repealing President Obama’s health care law, and Mr. Trump is now a few days from taking office. The public, however, knows little more about his proposal than it did in 2015.

Opinion: I’m a former health insurance CEO and this is what Obamacare repeal will do

On January 3, 2017
By J.B. Silvers

There’s a joke among insurers that there are two things that health insurance companies hate to do — take risks and pay claims. But, of course, these are the essence of their business!

Read more…