Mar 27, 2025
In part 2 of episode 469, host Stacey Richter discusses the implications of Medicare site neutral payments and Health Savings Account (HSA) reforms with James Gelfand, president and CEO of the ERISA Industry Committee (ERIC).
The episode details how plan sponsors should adapt to Medicare's site neutral payment policies aimed at curbing hospital consolidation and inflated prices through facility fees and markups. Gelfand provides insights into how HSA reforms currently in Congress could expand the scope of preventive care covered before deductibles are met, benefitting both employers and employees.
The conversation also touches on the challenges high deductible health plans pose and the potential benefits of codifying recent IRS guidance to allow greater flexibility in pre-deductible coverage. The discussion underscores the importance of plan sponsors staying ahead of Medicare policies to avoid higher costs.
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05:42 What does Medicare site-neutral payments mean?
08:59 How do markups play into the dynamics here?
09:52 Upcoming episode with Christine Hale, MD, MBA.
10:36 What does the “narrow” start for these changes mean?
11:42 What action steps should plan sponsors be taking?
13:01 What options do plan sponsors have in highly consolidated markets?
14:27 EP371 with Erik Davis and Autumn Yongchu.
14:53 EP448 (Part 1 and Part 2) with Shawn Gremminger.
15:46 Will this bill potentially make changes to HSA plans?
17:40 Why has the thinking behind healthcare usage changed since the inception of HSAs?
18:42 INBW41 with Stacey.
23:24 How are preventive care and first-dollar coverage connected within the context of HSAs?
25:48 Why would it be difficult to completely get rid of a high-deductible health plan and offer HSAs without them?