Welcome to the MCOL Blog

Please join the discussion with our panel of experts, as we cover a wide range of important topics shaping the business and future of health care.


Cadillac tax may hit over 25% of employers starting in 2018

By Claire Thayer, September 2, 2015

One of the provisions of the Affordable Care Act is the high-cost plan tax (HCPT), aka the ‘Cadillac’ tax,  will be imposed on health insurance companies as well as sponsors of self-funded group health plans beginning in 2018.  Plans that exceed cost thresholds will incur the excise tax.  For 2018, cost thresholds are $10,200 for an individual (single coverage) and $27,500 for family. The excise tax is.............Click to continue


More About Us, Less About Them

By Kim Bellard, September 1, 2015

Something Amazon just did is worth those of us in health care paying attention to.  It was the layoff of "dozens" of engineers at Lab126, Amazon's hardware development center, as first reported by The Wall Street Journal.  These were the first layoffs in the division's history.............Click to continue


Independent Pharmacy Accountable Care Organizations

By William DeMarco, August 26, 2015

The competition for Pharmacy Services has become brutal as large chain stores such as Walgreens and CVS, as well as big box stores like Target and Walmart, attempt to develop exclusive service contracts with large insurance carriers and Pharmacy Management Companies (PBMs). At the same time.............Click to continue


The Role of Master Data Management in Health Care

By Claire Thayer, August 25, 2015

Health Market Science tells us that Master Data Management (MDM) in health care encompasses everything from patient data to provider data detailing the treatments, procedures, modalities, products and processes which govern and describe patient interactions and outcomes. A recent.............Click to continue


Seven Things to Know About Medicaid Going Forward

By Clive Riddle, August 20, 2015

  1. The most current CMS report indicates total Medicaid and CHIP enrollment of 71,637,638; with 509,082 additional people were enrolled during the past 30 days in the most recent reporting month (May 2015.)
  2. .............Click to continue

Examining ACO Makeup Evolution During Past Three Years

By Clive Riddle, August 14, 2015

Compiling Accountable Care Directory Data, we can look at how the makeup of ACOs around the country has evolved from since 2012. MCOL’s HealthQuest Publishers just released version 2 of its 2015 Accountable Care Directory, and has published updated directory twice a year since mid 2012. We’ve compiled data from the directories to provide a look at ACO composition over time.............Click to continue


Pharmaceutical Industry in Transition

By Clive Riddle, August 7, 2015

KPMG has just conducted a survey of pharmaceutical and medical device companies, finding “their biggest commercial challenges coming from payers, surpassing hurdles posed by regulators, declining access to healthcare providers, and the move toward specialty drugs.”

Based on these findings.............Click to continue


The Most Difficult Part Of The Patient-Centered Medical Home

By Clive Riddle, July 31st, 2015

The medical home transformation for primary care, incorporating a team approach, technology, elements of care coordination and much more, has been a significant driver of change and innovation this decade. In the about to be released August issue of Medical Home News, the Thought Leaders Corner asks the question:  What was the most difficult part of the patient-centered medical home transformation that you experienced or observed? Here’s what the panel shared in their responses.............Click to continue


Snapshots of the Mega-Mergers

By Clive Riddle, July 24, 2015

With Anthem and Cigna’s merger announcement, the dance card has been filled out. Here’s what they had to say about their deal.............Click to continue


Accuracy of Provider Directories

By Claire Thayer, July 17, 2015

Beginning in 2016, health plans will face stiff penalties for failing update and monitor their provider directories. Kaiser Health News reports that inaccuracies in provider directories may trigger penalties of up to $25,000.............Click to continue


Nag On My Shoulder

By Kim Bellard, July 15, 2015

We seem to like to have help with our health. In addition to doctors, we might have a case manager, a health coach, a pharmacist, a personal trainer, or a nutritionist, to name a few.  But we soon may be able to have all of their expertise whispering in our ear 24/7.............Click to continue


How National Thought Leaders View The Post SCOTUS Public HIX World

By Clive Riddle, July 10, 2015

Earlier this month, Health Insurance Marketplace News published a supplemental edition of their newsletter, providing commentary from 27 ThoughtLeaders around the country at the SCOTUS King v Burwell decision. They were asked: “What’s your gut reaction to the ruling?.............Click to continue


Jurassic Park: Rise of the Health Insurers

By Kim Bellard, June 26, 2015

If you want to see dinosaurs fighting, stalking, and even mating, you don't need to go see Jurassic World.  Just pick up the business pages and see what is going on with the big health insurers, who seem intent on getting even bigger.

Whether anything actually comes of all the merger mania.............Click to continue


Some Things to Know and Ask in the Aftermath of the CVS/Target Deal

By Clive Riddle, June 19, 2015

Here’s some things to know in the aftermath of the announced CVS/Target deal . We can start with this list of deal points that the two companies provided in their press release announcing the acquisition and strategic partnership.............Click to continue


Health Plan Member Portals

By Claire Thayer, June 18, 2015

During the months of May and June, MCOL and LexisNexis conducted an e-poll of healthcare professionals on their involvement and insights with health plan member portals.  Respondents were categorized as Health Plan, Integrated delivery Network, Third Party Administrator (TPA), Self-Insured Employer, and Other. Overall, two thirds of the respondents indicated.............Click to continue


PwC and Milliman Examination of Medical Cost Trends

by Clive Riddle, June 10, 2015

PwC projects a medical cost trend for 2016 of 6.5%, netting down to 4.5% after benefit design changes. Milliman tells us that the 2015 actual trend was 6.3%, up from 5.4% in 2014.

PwC’s Health Research Institute this week released their tenth annual Behind the Numbers report, which includes a “projection for the coming year’s medical cost trend based on analysis of medical costs in the large employer insurance market.............Click to continue


Track 3 For Medicare ACOs

by Clive Riddle, June 5, 2015

CMS has just issued a 592 page MSSP ACO final rule resulting from their proposed rule issue in December, which received 275 stakeholder comments.

Here’s what CMS, in their own words, says the new final rule will accomplish.............Click to continue


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MCOLBlog Team

Kim Bellard
KB Consulting
Columbus, OH

Krista Burris
Healthcare Strategy Consultant
San Francisco Bay Area

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William DeMarco
President
DeMarco and Associates
Rockford, IL

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Laurie Gelb
Vice President
ORC International
Seattle, WA

Nate Kaufman
Managing Director
Kaufman Strategic Advisors
San Diego, CA

Cyndy Nayer
Founder and CEO
Cyndy Nayer's Center of Health Engagement
CyndyNayer.com

Lindsay Resnick
Chief Marketing Officer
KBM Group: Health Services

Clive Riddle
President
MCOL
Modesto, CA

Marshall Riddle
Senior Analyst
MCOL
Modesto, CA

Claire Thayer
Vice President
Business Development
MCOL
Portland, OR