From ERISA to CAA: How Has Employer’s Fiduciary Responsibility Changed Over Time?
Though ERISA is often thought of as an issue for retirement plans, the law has always applied to employer-sponsored health benefit plans. The Consolidated Appropriations Act of 2021 (CAA) sought to put a spotlight on the issue by clarifying responsibilities of health benefit plan fiduciaries and the third-party service providers they contract with. Yet, 3 […]
Market Forces Created Our Dysfunctional Health System. Now We Must Harness Them to Drive Change.
American health care is in crisis. In this MTVA Unscripted episode renowned scholar Ge Bai, PhD, CPA shares insights about dynamic underlying problems in the system and why she believes there is reason for hope. In her words, “We have to cherish the opportunity in front of us. We’re at a point that public awareness […]
PBM Problems (Part 1): Who do Brokers and Consultants Really Work for? Risks for Plan Sponsors w/……
This episode is a must-listen for all plan sponsors and employers! “In American business, you don’t expect your major vendors to be profit-gouging you, and you don’t expect these major consulting firms to be taking their side instead of yours.” – Paul Holmes This is the first episode in a new series from the “MTVA Unscripted” podcast […]
Transforming Healthcare: The Impact of Purpose-Driven Approaches
Join MTVA for a conversation with Dr. Scott Conard, MD, as we delve into the transformative power of purpose-driven healthcare. From fee-for-service models to data-driven initiatives, we explore improving healthcare outcomes, challenges in elder care, and the importance of a social model of care. Discover how autonomy, mastery, and purpose shape healthcare success and the […]
How One Health System Has Embraced Value-Based Care: Mount Sinai’s Population Health Journey
The MTVA team delves into the challenges and obstacles faced by a leading healthcare system in its transition into a patient-centered care model. Joined by Mount Sinai Health System’s CMO and Senior VP of Population Health, Dr. Arshad Rahim, we discuss the complexities of aligning financial incentives with outcomes-based care principles, leveraging data-driven insights to […]
Wake-up Call: The Johnson & Johnson Prescription Pricing Scandal
It’s finally happened. After years of speculating what an employee complaint against an employer for breach of fiduciary duty would look like, it has arrived. And this one doesn’t disappoint. Johnson & Johnson is being sued by its employees, alleging that their health plan overpaid for prescription drugs, costing workers money. This suit touches on […]
Optimism in the Journey To Value-Based Healthcare
In the last episode of 2023, MTVA team leaders Jeff Hogan, John Rodis, MD, and Lisa Trumble dish out candid insights into the state of value-based healthcare and take a glimpse into 2024. They unpack the trend of primary care physicians shifting gears from employment to independence, delve into the pivotal role of employers in […]
Unraveling the Complexities of Pharmacy Benefits: PBMs, Drug Pricing vs. Drug Efficacy
The MTVA team engages in a thought-provoking conversation with AJ Loiacono, CEO and Founder of Capital Rx, delving into the intricacies of pharmacy benefits and the challenges faced by employers in navigating the healthcare landscape. Loiacono provides insights into the complexities of drug pricing, the far-reaching effects of the Consolidated Appropriations Act (CAA), high-cost drugs, […]
A Rising Tide Lifts All Boats: How one healthcare institution inspires transformation through data-driven
Moving to Value Alliance 11/1/2023 The MTVA team talks to Dr. James Caillouette, the visionary behind Hoag Orthopedic Institute, a joint venture orthopedic specialty hospital in Irvine, California, about the path to the establishment of a groundbreaking healthcare institution that prioritizes shared ownership and governance between hospitals and physicians. Jamie discusses the factors that drove […]
