Signed, Sealed… Sued?
Signed, Sealed… Sued? If You Didn’t Write the Contract, You’d Better Rewrite the Rules. Most health plan contracts come pre-written—by brokers, vendors, or consultants. But when…
Author: Steve Ditto
Steve Ditto is a healthcare executive, author, and advisor with more than 30 years of experience across employer health benefits, PBM contracting, healthcare analytics, digital health, physician performance, and health systems science. He is a Board Advisor to Nautilus Health Institute, a Fellow at the Thomas F. Frist, Jr. College of Medicine, leads Contract X-Ray, and is the author of The Middleman’s Cut and the weekly newsletter of the same name.
The Death of Common Sense
When Five-Figure Pills Deliver Three-Week Benefits, Fiduciaries Must Intervene
The PBM Reform Playbook
The PBM Reform Playbook State Legislatures Are Doing What Congress Hasn’t Executive Brief State legislatures are cracking down on PBM profit games—banning spread pricing, requiring rebate…
PBM Illusions, Exposed
PBMs thrive on confusion. Bold employers are demanding receipts—and revealing just how costly that confusion really is.
What Health Plans Haven’t Yet Learned from 401(k)s
What Health Plans Haven’t Yet Learned from 401(k)s Same law. Same risks. Bigger blind spots. Executive Brief The fiduciary failures we fixed in retirement plans are…
What I Learned from 25 Newsletters
What I Learned from 25 Newsletters And a Lot of Lawsuits Executive Brief Welcome to Issue #26 of The Health Plan Compliance Advantage. Most newsletters don’t…
The Fiduciary Lawsuit That Could Change Everything
The Fiduciary Lawsuit That Could Change Everything No More “We’re Just Administrators” TPA Defense Executive Brief Can a TPA avoid ERISA liability by calling itself an…
Is Your Health Plan Killing the Corner Pharmacy?
Is Your Health Plan Killing the Corner Pharmacy? How employer decisions fuel pharmacy closures—and what you can do about it Executive Brief Independent pharmacies are disappearing—hurting…
Employers Say They Put People First
Employers Say They Put People First Until Someone Gets Sick When that spreadsheet-driven plan design causes delays, denials, or dropped coverage, it’s not just a bad…
Why Companies Stick With Bad Vendors
Why Companies Stick With Bad Vendors The Psychology of Loyalty and the Legal Risk of Doing Nothing You’ve seen the headlines: lawsuits, subpoenas, FTC crackdowns. PBMs,…