Employer health benefits costs likely to soar again in 2025

By Dawn Kawamoto - According to a recent Mercer report, employers across the nation are expected to face a large increase in the total cost of healthcare benefits in 2025, despite many having taken cost-cutting measures this year. Read Full Article… 

HVBA Article Summary

1. Rising Healthcare Costs: Healthcare costs are projected to rise 5.8% in 2024, continuing a trend of record-high increases compared to the 3% average from 2012-2022.

2. Employer Adjustments: Employers are raising premiums and cutting benefits to manage costs while balancing employee affordability concerns.

3. Drug Costs and Consolidation: Expensive prescription drugs and health system consolidation are major drivers of rising healthcare expenses.

Balancing health benefits and financial wellness on a budget

By Rob DiMase - Our economy today faces several significant challenges. For organizations sponsoring employee benefits, maintaining a budget while providing essential health benefits is more crucial than ever. Read Full Article… ^{_{(Subscription required)}}

HVBA Article Summary

1. Survey employees to tailor benefits: Use employee surveys to align benefits with their needs, ensuring value and satisfaction while optimizing company spending.

2. Leverage tax-advantaged accounts and funding: Promote FSAs, HSAs, and alternative funding options to reduce healthcare costs and boost financial wellness.

3. Optimize insurance costs: Take advantage of high-interest rates to secure lower life and disability coverage costs, benefiting both employers and employees.

Can Weight Loss Drugs Also Treat Addiction?

By Megan Brooks - A new study provides more evidence that glucagon-like peptide 1 receptor agonists (GLP-1 RAs) used to treat diabetes and obesity could be repurposed for opioid use disorder (OUD) and alcohol use disorder (AUD). Read Full Article… 

HVBA Article Summary

1. Reduced Overdose and Intoxication: Patients with OUD or AUD taking semaglutide or similar drugs had a 40% lower rate of opioid overdose and 50% lower rate of alcohol intoxication compared to those not taking them.

2. New Treatment Possibility: The study suggests GIP/GLP-1 receptor agonists could be potential treatments for substance use disorders, though more research is needed.

3. Further Research Needed: Experts caution that while these drugs may reduce severe intoxication, it’s unclear if they help reduce or stop substance use, calling for more clinical trials.

What is a qualified medical expense, according to the IRS?

By William Sweetnam, Jr. - We all know that health flexible spending arrangements (FSAs), health reimbursement accounts (HRAs) and health savings accounts (HSAs) provide a tax-effective way of funding an employee's health care expenses. Read Full Article… ^{_{(Subscription required)}}

HVBA Article Summary

1. IRC Compliance: FSAs, HRAs, and HSAs must follow IRS rules, with strict claim substantiation to avoid hefty tax penalties for employers and employees.

2. IRS Misrepresentation Warning: The IRS cautioned that personal expenses, like healthy food, can't be reimbursed under these plans, even with a doctor's note.

3. Congressional Action Needed: To expand qualifying medical expenses, Congress must amend the IRC, as current rules remain unchanged since the pandemic adjustments.

UnitedHealth, CVS and Humana increasingly deploy AI and deny post-acute care claims, Senate report finds

By Noah Tong - The country’s three largest Medicare Advantage (MA) insurers obstruct seniors’ ability to receive post-acute care, a scathing report from the U.S. Senate Permanent Subcommittee on Investigations shows. Read Full Article… 

HVBA Article Summary

1. Increased Denials Through Technology: From 2019 to 2022, UnitedHealthcare, CVS, and Humana used automation to deny post-acute care claims at much higher rates, with Humana's denials increasing 16 times in 2022.

2. Profit Over Patient Care: The investigation found insurers used AI to cut claims approvals, prioritizing cost savings. CVS alone projected $77 million in savings through reduced skilled nursing facility expenses.

3. Regulatory Action Needed: The Senate subcommittee urged CMS to audit and regulate insurers’ AI-driven prior authorization systems, which are pressuring medical professionals to prioritize cost-cutting over patient care.

New study shows employers’ support of women’s health is on the rise

By CVSHealth - A 2024 new study commissioned by CVS Health® and conducted by Forrester Consulting, Employers Evolve Health Benefits For Working Women, surveyed more than 300 health benefits decision makers at employers nationwide and identified employer sentiment on women’s health benefits. Read Full Article… 

HVBA Article Summary

1. Reimagining Women’s Health Benefits: Companies are prioritizing comprehensive health benefits for women to fill care gaps, with 69% of decision-makers focusing on targeted resources for conditions like pregnancy and menopause.

2. Increasing Access to Care: 75% of employers plan to boost healthcare access through telehealth and clinics, while 80% seek culturally competent partners to better support diverse health needs.

3. Mental Health and Specialized Care: Mental health is a priority for 46% of employers, and 75% are confident in their menopause benefits, with 26% offering specialized midlife care programs.

Novo declares Phase 3 cardiac outcomes trial win for oral GLP-1

By Ayisha Sherma - Novo Nordisk’s oral semaglutide lowered the risk of certain heart events in a late-phase study in people with type 2 diabetes and related metabolic conditions, sparking plans to file for a label expansion for the non-injectable form of its GLP-1 drug. Read Full Article… 

HVBA Article Summary

1. SOUL Trial Success: Rybelsus reduced major cardiovascular events by 14% in the Phase 3 SOUL trial involving 9,650 participants with type 2 diabetes and cardiovascular or kidney disease.

2. Regulatory Filings: Novo Nordisk plans to submit trial results to US and EU regulators by year-end, with full data to be shared in 2024.

3. Sales and Impact: Rybelsus sales grew 50% in Q2 2024, while Wegovy’s expanded FDA approval has led to broader Medicare coverage for weight loss.