Steve Ditto on LinkedIn: Being disabled has its perks. Property tax reductions and social security… (2024)

Being patient-centric is important. But you can’t really understand patient needs until you’ve been one. Or maybe heard one speak. That’s why you should go to RosettaFest.I’m happy to join Ann Lewandowski and moderator Ryan Jankord to speak about our experiences as patients navigating the healthcare system. Our goal is to provide insights into the benefits employees will need and value while having a positive impact on the bottom line. Should be a good session for employers, health plans, brokers, and advisers.When Ann and Ryan asked what things would have improved my experience, 6 things quickly came to mind:1. 2nd opinion service2. Specialist navigation3. Centers of excellence4. Price transparency tools5. Low cost Rx options6. Out of network claims and inappropriate billing supportI’d be very interested in hearing your perspective. Leave your thoughts in the comments below!Health Rosetta Join us at RosettaFest 2024: A Work of Heart • September 11-13 • Washington D.C.

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Well I finally made an insurance decision. I promised to report back after much input from the benefit pros. With an end of month deadline staring me in the face I have decided.To kick the can down the road. I’m sticking with my COBRA HDHP plan for another 11 months until I run out of eligibility. I think it’s a good decision all things considered. But I don’t feel great about it. I’d liken it to “Better the devil you know than the devil you don't.”Last year I paid $29K in premiums and $6K out of pocket for a total spend of $35K. The plan paid $142K after discounts which included 1 week-long ICU stay, 2 different infusion therapies, 5 MRIs, 5 CTs, 4 EMGs, 3 X-rays, 2 Echos, and 1 PET. Not to mention a bunch of specialists along the way.I don't expect nearly the same intensity this year. But I do know my maximum spend will be another $35K even if my crystal ball is cloudy. With other options, I worry about pre-auths and 30% co-insurance particularly on infusions. I just don't have the same level of certainty with other options. Looking forward, given my diagnosis was less than 12 months ago I don’t seem to qualify for underwriting in either traditional plans or alternative approaches despite being in remission after treatment. Finding a plan on the Exchange seems to be a viable option. It’s probably what I’ll do when I’m forced to switch. The choices seem to be mostly HMOs with my local specialists in-network. However, Mayo would be out of network and I’d need to pay cash. Since I’ve taken the last 10 months off to focus on the healing process I likely would qualify for a subsidy. I guess that’s one perk of being sick for a while.With this decision it feels like I’ve taken the advice I received. Going forward I plan to:1. Pay cash for basic services2. Use tools like BILLY to identify best pricing3. Insure against catastrophic risk of hospital costs4. Consider the Exchange with no limits on pre-existing conditionsI can't tell you how appreciative I am of all the comments and guidance I’ve received.Another big shout out to all the collaborators including: Bill Hennessey, M.D., Stephanie Ziegler, Corey Colman, Kimberly Carleson, Ronda Cobb, BSME, Ann Lewandowski, Greg Bell, William Sarraille, and Jeff Evans, CRM, ACSF Passionate Risk/Insurance Educator-Coach-AuthorPlease leave comments below especially if I missed or mangled anything!

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Know what I hate? Buying something then finding a better price. Know what I hate even more? Finding out I paid 2x-5x too much. That’s what I learned using www.trybilly.app to compare medical prices.I had a lot of medical imaging last year. 5 MRIs, 5 CTs, 3 X-rays, 2 Echos, and 1 PET. No, I’m not worried about all the radiation (I’ll be dead before it catches up with me). But I am worried about the cost of all these tests because I have to repeat some this year.Like most people, I never gave the cost of imaging a second thought. My insurance company must have negotiated great rates, right? Wrong. My insurance company was at the market average or higher. Whereas the cash price was often significantly lower. And since I was on a high deductible health plan these costs were coming out of my pocket. Using the BILLY app I was able to view the cash price vs. what I paid through insurance at locations all around town. The variation was stunning. To add insult to injury I was literally driving past the low cost providers to visit the highest cost providers. Try BILLY for yourself to see what you might save. You'll need to look up procedures by CPT code which you can find on your EOB or via a Google search. I’m attaching a list of CPT codes for MRIs you can use to get a quick first look at Price Transparency.Be a #ConciousConsumer. Let's all embrace #PriceTransparency and stop overpaying for medical services!Leave comments below to let us know what you find.

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One benefit of getting older is I now enjoy reading AARP magazine. This headline caught my eye: “Most Americans Flunk Retirement Fluency Test.” How would you fare? Compare your score in the comments.Here’s the 5 question version of the test:1. Which statement about Social Security is false?A. The amount someone receives in Social Security benefits depends upon his/her earnings during the last two years of full-time employment.B. A worker receives Social Security benefit payments if he/she becomes disabled before retiring.C. Social Security benefit payments will continue as long as an individual is alive, no matter how long he/she lives.D. Don’t know. 2. On average, Medicare and other government programs cover how much of an individual’s health care expenses in retirement?A. Over 90 percent.B. About two-thirds.C. About one-half.D. Don’t know.3. Latisha plans to start saving for retirement by setting aside $2,000 this year. Her employer offers a 401(k) plan and fully matches a worker’s contributions up to $5,000 each year. Under which scenario does Latisha have the largest amount in retirement savings at year-end?A. She contributes $2,000 to the 401(k) plan and invests the money in a mutual fund that earns a 5 percent return during the year.B. She contributes $2,000 to an IRA (individual retirement account) and invests the money in a mutual fund that earns a 5 percent return during the year.C. It does not matter — she will have the same amount of year-end savings either way.D. Don’t know.4. Susan worries about living a long life and running out of money. What is the best way for her to address that possibility?A. Buy an annuity.B. Buy life insurance.C. There is nothing she can do about this.D. Don’t know.5. [For men] On average in the U.S., how long will a 65-year-old man live?A. About 14 more years (age 79).B. About 19 more years (age 84).C. About 24 more years (age 89).D. Don’t know.[For women] On average in the U.S., how long will a 65-year-old woman live?A. About 17 more years (age 82).B. About 22 more years (age 87).C. About 27 more years (age 92).D. Don’t know.*****Here are the answers: 1. A; 2. B; 3. A; 4. A; 5. B, BProbably not surprising but Boomers fare better than younger generations, but correct answers are elusive for all ages. 3 in 5 U.S. adults got at least three of the questions wrong.Don’t be shy about putting your score in the comments below!Personal accountability is the first step toward improvement.

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Brokers and health plans have a “classic conflict of interest.” Most employers seem to act like they don't know what’s happening. But Marshall Allen knew. And he documented it in Propublica articles for years.Back in 2019, he wrote “Behind the Scenes, Health Insurers Use Cash and Gifts to Sway Which Benefits Employers Choose.” If you ever wondered why healthcare costs have increased year over year, this article gives you a pretty good view.Incentives like cash and gifts may sound like typical business tactics. But don't forget, in this case the funds for these perks aren't coming out of the health plan’s pockets. They come from employers and employees in the form of higher premiums. Don’t get me wrong. I’m all for professionals being paid for their valuable services. But there are much better ways to get paid that align broker and employer interests.One way is Health Rosetta. Dave Chase, Health Rosetta-discovering archaeologist developed a blueprint to save companies money without sacrificing benefits. By embracing his approach, brokers can become value added “benefit advisers” without any of the broker conflicts. Advisers can share in the savings and be paid well without resorting to financial arrangements that drive up costs.Maybe it is possible to do good and do well.Read this article and more of Marshal Allen’s Propublica work at:https://lnkd.in/gTSdJ-BfPlease leave comments below!

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We lost a powerful healthcare voice and patient advocate this weekend. Marshall Allen, author of "Never Pay the First Bill", passed away. He and the advice dispensed in his book helped me and many others.I had a lot of medical bills last year. I felt many were inaccurate and erroneous. When I went looking for help I came across Marshall’s posts on LinkedIn. I downloaded his book and immediately put it to use. When I ran into a snag, Marshall kindly gave me advice. Ultimately, his guidance helped me save almost $7,000.Marshall’s posts often had an amusing meme. I asked him if he had a social media manager who found them. He said “No, half the fun of each post is finding the perfect meme.” He clearly enjoyed his work and communicating it to others.I purchased the Kindle edition of his book. Now I think I'll buy the hardcover so I always have it on my shelf. Do yourself a favor and support his legacy and family by purchasing his book at Amazon. https://lnkd.in/gwj3j6E9

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The benefit pros have really come through! I’ve received excellent advice on yesterday’s post. I still have a lot of research ahead but the first cut has been promising. I’m going to report back on the full findings but here’s where I am:Summary of the feedback so far:1. Broad consensus around high deductibles and paying cash for basic services2. Tools like BILLY and others can help identify best pricing3. Need to insure against 1-in-100,000 catastrophic risk of hospital costs4. However, no clear providers of catastrophic coverage5. Exchange has no limits on essential benefits and pre-existing conditionsA few early surprises:1. Exchange has HDHPs close to the current one available through my COBRA2. You can even get an HSA eligible Bronze plan (I’m a big fan of HSAs)3. I had no idea the subsidies were so generous (who’s paying for that?!?) 🤣Still have a few issues to run down:1. Need to better understand the price of infusions and 30% co-insurance2. Mayo is OON and need to get a cash price for specialist visits and testsI can't tell you how appreciative I am of all the comments and guidance I’ve received.More to come as my exploration continues. Big shout out to all the collaborators including: Bill Hennessey, M.D., Stephanie Ziegler, Corey Colman, Kimberly Carleson, Ronda Cobb, BSME, Ann Lewandowski, Greg Bell, William Sarraille, Jay DJ, and Jeff Evans, CRM, ACSF Passionate Risk/Insurance Educator-Coach-AuthorKeep that advice coming!Please leave comments below especially if I missed or mangled anything!

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“In Medicine, the Morally Unthinkable Too Easily Comes to Seem Normal.” This NYT article explores one of the great mysteries of human behavior: how institutions create a social world where unthinkable practices come to seem normal. The focus is on hospitals and physician training. It’s a fascinating view into the inner workings of medicine. But the concepts apply equally to health plans, their leadership, and the companies that enable them. What started as a great idea to help people has morphed into a profit above all else enterprise. After looking under the covers, health plan services can seem like schemes designed to separate patients from their money. And so many people are involved. Many avert their eyes to avoid angering vindictive organizations and risking their livelihoods. Others have fallen victim to groupthink and are still convinced they are doing righteous work. Even when the outside world catches on and condemns a practice, insiders typically insist the outsiders don’t really understand.A small but growing group does understand and is now focused on highlighting and righting this wrong. Movements like Health Rosetta are pointing the way. Using their approaches, it’s possible for public and private employers and unions to avoid the schemes and reduce their health benefits spending by 20% or more. All while improving the quality of care for plan members.It's time to break from the groupthink and be the change you want to see in the world. I’ve attached a free link to the article at: https://lnkd.in/d33KB88hDo yourself a favor and read the letters to the editor as well:https://lnkd.in/dHYfdTBPPlease leave your thoughts and comments below!

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Benefit pros: what do you recommend? My COBRA is set to renew end of May. I can continue a HDHP with $3000 deductible and $6000 OOP. Because of pre-existing conditions I’m told my only option is the Exchange. What do you think?Unfortunately this is not a hypothetical question. It's an all too real world personal example. Here’s my H&P in brief: For 30 years I was never sick, never hospitalized, never had a procedure. Then last year at 62 I developed an autoimmune condition. I saw more specialists and had more tests than I ever thought possible. After a visit to the Mayo Clinic I’ve been treated with an infusion therapy. Based on my latest bloodwork the doctors say I’m now in remission. It’s hard to predict the future but I don't foresee another acute episode or anything close to the medical intensity of the past year. But I will need periodic blood tests, probably a CT or two, and a checkup visit in Rochester.The renewal notice came in the mail this evening for $1200/month. I’d love to reduce that cost. I’m open to new approaches. But I’m loath to move to any plan my doctors don't participate in. I know there are a ton of deeply experienced benefits experts on LinkedIn. It would be great to get your insights on other options.Please share your thoughts in the comments below!

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