Executive Summary On June 23, 2025, Health and Human Services Secretary Robert F. Kennedy Jr. and CMS Administrator Dr. Mehmet Oz announced a new, industry-wide pledge from more than 30 major health insurers aimed at fixing one of the most frustrating choke points in U.S. healthcare: prior authorization. Collectively
Executive Summary The "One Big Beautiful Bill" (H.R. 1) currently under consideration in Congress proposes significant changes to the Affordable Care Act (ACA) marketplaces, Medicaid, and employer-sponsored health plans. Key provisions include the expiration of enhanced ACA subsidies, introduction of stringent administrative measures, implementation of Medicaid work
Executive Summary On May 12, 2025, President Donald J. Trump signed Executive Order 14297, directing federal agencies to implement a “Most Favored Nation” (MFN) pricing model for prescription drugs. The policy mandates that the U.S. not pay more than the lowest price paid by peer nations for certain medications.
GLP-1s, Obesity, and the Employer Cost Curve: Trusting the Data, Verifying the Strategy A recent report from a large consulting firm has raised eyebrows across the benefits world. The headline: GLP-1 medications may finally be bending the healthcare cost curve. For employers grappling with rising claims tied to obesity, diabetes,
Health care costs in the U.S. are overwhelmingly driven by prescription drug prices, which continue to outpace inflation and international benchmarks, straining patients, providers and public coffers. Direct Cost Increases for Drugmakers Johnson & Johnson alone expects to absorb roughly $400 million in tariff‐related expenses this year, driven
Healthcare today is overcomplicated sometimes for no reason other than the legacy systems and processes that have been in place. We are always looking for innovative ways to improve outcomes, lower costs, and offer better employee experiences. One approach gaining significant traction is Direct Primary Care (DPC) — a healthcare delivery
“My coworker dropped 30 pounds in 3 months.” “My health plan costs just spiked—what the heck is Wegovy?” “Are we paying for this? Should we be?” If you’re in HR or manage benefits, you’ve heard the buzz. You’ve seen the pharmacy reports. You’ve felt the
While trade tariffs might sound like an issue for global economists and policy wonks, they can have very real consequences for U.S. employers — especially when it comes to employee benefits. We work closely with CFOs, HR leaders, and operations teams who are watching margins tighter than ever, or their
In the first two weeks of his second term, President Donald Trump signed a series of executive orders aimed at rolling back Biden-era policies and advancing his own administration’s priorities. Among the most impactful for employers are the revocations of Executive Orders 14009, 14070, and 14087, which focused on