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Small Businesses Pursue Health Law 'Loophole'
NorthBay Adventure is the kind of small business that could be expected to buy medical insurance for workers under sweeping health-act rules taking effect in 2014. But executive director George Comfort says that’s not likely to happen.
Instead, NorthBay became self-insured last year, paying most of its workers’ health costs directly, a practice more typical of large employers. The decision to self-insure was about free choice, savings and what’s best for his company, Comfort says. But others see it as a threat to the Affordable Care Act. As more small employers like NorthBay avoid the health act’s requirements through self-coverage, small-business marketplaces intended to cover millions of Americans could break down and become unaffordable, they say.
Read the full story: http://bit.ly/YfxAie
Source: Kaiser Health News (in collaboration with USA Today)
AI Meets Medicare: Inside CMS’s WISeR Model With Sanjay Doddamani, MD, MBA, Part 2
August 5th 2025In this second part of his interview with The American Journal of Managed Care®, Sanjay Doddamani, MD, MBA, a former senior advisor to CMMI and founder and CEO of Guidehealth, continues a dialogue on the future of value-based care and the promise—and limits—of AI-enabled innovation, reflecting on challenges like rising Medicare costs and patients’ growing financial burdens.
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Trump Directs Pharma Companies on Cutting Drug Prices Under Most-Favored-Nation Order
July 31st 2025President Donald Trump has sent letters to pharmaceutical companies, aiming to compel them to lower drug prices in the US to match the lowest prices offered in other developed nations, a move that could significantly reduce costs and disrupt the current system of pharmacy benefit managers.
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