What Health Plan Lawsuits Reveal
What Health Plan Lawsuits Reveal And How to Stay Out of Them You may never find yourself in court over your company’s health plan. But that…
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.
Boardroom Risk Alert
Boardroom Risk Alert Fiduciary Failure Leads to Personal Liability Inflation, wage pressure, rising drug costs, and tariffs on products and supplies are squeezing health plan budgets.…
Compensation Disclosure
Compensation Disclosure Time for Brokers to Come Clean The world of employee benefits is changing—and so is the expectation around who works for whom. For decades,…
Making Prudent Vendor Decisions
Making Prudent Vendor Decisions A Fiduciary and Strategic Imperative Here’s the uncomfortable truth: Many of the problems plaguing employer health plans are compliance failures rooted in…
Why Employees Pay More for Prescription Drugs
Why Employees Pay More for Prescription Drugs What Can Employers Do About It? It’s a question every health plan sponsor should be asking: Why are employees…
Smarter Approach to PBM Management
Smarter Approach to PBM Management The PBM Landscape The Big 6 PBMs—CVS Health, Express Scripts, OptumRx, Humana Pharmacy Solutions, MedImpact, and Prime Therapeutics—control 94% of the…
Rising Risk of Pharmacy Benefits
Rising Risk of Pharmacy Benefits Board Directors Are Now Named Defendants Recent lawsuits against major corporations highlight a growing risk: PBM mismanagement is leading to overspending,…
Controlling Medical Benefit Drug Spending
Employers target PBMs to curb drug costs but often miss a big issue—specialty J-code drugs billed under medical benefits
Mental Health Benefits
Adequate mental health benefits are a fiduciary responsibility and growing legal risk for employer health plans.
Smart Shopping for Healthcare
Smart Shopping for Healthcare The Employer’s Role in Price Transparency Imagine running a business where employees make purchasing decisions without knowing the cost—only to find out…