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How Clinical Informatics Can Uncover Major Saving Opportunities in Healthcare Plans

"Analyzing healthcare plan data shows the direction of spending and care, but it takes clinical informatics to understand why those trends are occurring -- and to find the most cost-effective ways to deliver care for plan sponsors."

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The Way Forward for National Health Service Health Informatics (PDF)

20 pages. "[The report] starts with a summary of ... recommendations, a brief examination of where the NHS is headed, and an assessment of NHS CFH now. [It goes] on to list the strategic changes that are necessary, and the detail behind ... proposals. Finally [it suggests] which proposals should be regarded as a priority."  MORE >>

Interview with Author of 'When I'm Sixty-Four: The Plot Against Pensions and the Plan to Save Them'

Transcript from the interview. Excerpt: Professor Ghilarducci, explain what's happening now in light of all -- well, Obama just spoke on the economy yesterday. TERESA GHILARDUCCI: It's really the end of a thirty-year experiment with a do-it-yourself pension system. The United States stood above all other nations in saying, 'Look, we're going to hand over this saving and investing responsibility over to individuals. They want control. The stock market is healthy.'  MORE >>

Who Will Hire Me When I'm 64? Challenges in Increasing the Employment of Older Workers

Transcripts of the opening remarks and presentations of the December 4th event.

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$200 Billion Annual Opportunity from Using Medicines More Responsibly

"Patients not adhering to their doctors' medication guidance experienced complications that led to an estimated $105 billion in annual avoidable healthcare costs.... The largest avoidable impact is seen in diabetes, where such delays increased outpatient visits and hospitalizations.... Some signs of improvement are evident in the responsible use of antibiotics.... Many efforts are underway to address the underlying causes of avoidable spending and to improve medication use."

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Study Points to a Declining Cost Curve for U.S. Medicines in 2012

"[T]otal dollars spent on medications in the U.S. reached $325.8 billion last year, or real per capita spending of $898, down $33 from 2011. Underlying drivers for the overall decline in healthcare service use included fewer patient visits to office-based physicians, fewer non-emergency admissions to hospitals and outpatient facilities, and a less severe flu season in the early part of 2012. Patent expiries in 2012 contributed $28.9 billion to the reduction in medicine spending. This was their largest-ever impact as millions of patients accessed lower-cost generic versions of additional medicines."

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I'm Late! I'm Late! For a Very Important Form 5500 Date!

"Name a way that plan sponsors traditionally make mistakes and blow the Form 5500 deadline: [1] Completely ignores communications from service vendor; [2] Doesn't get started early enough on mandatory audit; [3] Starts audit, but finds major problems and can't fix them timely; [4] Has an owner-only plan and doesn't realize it needs a Form 5500; [5] Change of personnel causes communication breakdown.... The good news here is that, even when a Form 5500 is not filed timely, there is an easy way to fix the problem."  MORE >>

Like Most Americans Who Have Health Insurance (and Most Do), I'm Reasonably Happy with What I Already Have

"And like many Americans, I'm willing to take the President at his word from the campaign trail -- that if you like the insurance you have, you'll get to keep it. But as I study the text in the two bills that will have to be merged to create legislation to fulfill that promise -- well, I have to tell you, I'm not sure how that's going to happen."  MORE >>

Mission (Im)possible: Overcoming the Status Quo in Health Coverage to Offer More Personalization

"[M]any insurers have begun moving toward a 'supermarket' of various offerings, most likely amassing many segment-centric assets.... [Tailoring] health plan offerings reactively to consumer demand ... is achieved by adding hybrid products that address specific customer needs or by stitching together a marketplace of add-on point solutions.... [S]ome insurers are using the startup approach to design new care models and coverage plans. The risk is that it requires scale to succeed."

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Born in the USA, But I'm a Cool Rockin' Employee Not in the USA Now

"Employers may need to consider customized health care solutions to specifically cover employees living in a foreign country.... Typically, qualified retirement plan participation is not affected for U.S. citizens living and working abroad for a limited period of time.... Employers should also consider childcare benefits, employee wellness programs, tuition reimbursement, travel insurance and expense reimbursement benefits[.]"  MORE >>

'You're Gonna Miss Me When I'm Gone'

"Each of these pieces of guidance, when taken collectively, demonstrate an effort on the part of the DOL to target current plan procedures that ultimately lead to future issues with Missing Participants. In other words, current actions that plan fiduciaries take to minimize Missing Participant issues in the future are as important as the actions they take to find Missing Participants once the issue arises."

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I'm Not a Fiduciary -- It's That Other Guy

"A 2017 [DC] plan survey ... indicates that there has been no improvement in this percentage of corporate plan decision-makers who don't understand that they are fiduciaries. 17% even thought that they could pass on all of their fiduciary responsibilities to third parties such as their provider, recordkeeper or investment adviser."  MORE >>

How I'm Fixing Your 401(k)

"When you dig into the details and the relationships that outside vendors have with legacy 401(k) providers, it's clear that the industry has lost focus on the goal, which is to give employees the opportunity to save as much as possible for retirement. You start to notice all of the hands in the cookie jar: TPAs, fiduciaries, recordkeepers, fund managers, broker/dealers, sponsors, custodians, RIAs, and on and on.... When I was thinking about my goal, providing a successful retirement for my employees, I simply could not justify that fee situation when trying to account for value in each of those services in a retirement account."  MORE >>

Co-Fiduciary Liability of 3(16) TPAs: 'I'm Outta Here' May Not Be Enough (PDF)

"[W]hat are your responsibilities [as a TPA who has agreed to take on plan administrator responsibilities for a retirement plan covered by ERISA] if you become aware that the plan sponsor or trustee is proposing to take or has taken actions that harm the plan? ... [M]ere resignation is not sufficient if you are a fiduciary. In fact, only resigning may make you liable for the wrong-doing that you are attempting to forestall.... Perhaps the first thing you should do is put your client on notice that your interests may end up being adverse to your client's.... Second, you should be prepared to 'ring the bell' when there is a breach of duty by another fiduciary."

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The Illusion of Protection: 'I'm a Fiduciary, But, But, But ...'

"[It] appears that the SEC has failed to enforce the fiduciary standard correctly ... And it also appears that many large Wall Street firms are putting themselves (and their advisors) at risk, by relying upon 'mere disclosure' as the means of 'managing the conflict of interest.' The evidence of these practices is found in the SEC disclosure document required of these firms, which are publicly available documents."

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Really? I'm Saving Too Much for Retirement?

"[T]here are too many variables that change during retirement, and retirement spending on average does not increase at the same level of inflation. In fact, the higher an employee's pre-retirement income is, the lower the percentage replaced needs to be. It's hard to argue that a person earning $200,000 needs to replace as much income as someone earning $20,000 to cover their basic needs.... [R]etirees may actually only need to save 50-60% [of pre-retirement income]. That's 20% less than the conventional rule of thumb."  MORE >>

I'm Not an 'Applicable Large Employer' Under the ACA -- Or Am I?

"[M]ake sure you understand the controlled group rules and take employees of controlled groups into account when determining if you are an applicable large employer under the Affordable Care Act. If your organization employs close to 50 employees now and you want to avoid being an applicable large employer for purposes of the employer shared responsibility mandate, keep a careful eye on your full-time hiring and the number of hours your non-full-time employees work throughout 2013."  MORE >>

Retirement Myths: I Can Start Saving For Retirement When I'm 40

"Waiting to start to save until you are 40 is a big financial mistake. You have already let the key years for saving pass you by. If you start at forty and plan to retire at age 67 you have 27 years of savings and investing. But if you start at age twenty you have 47 years."  MORE >>

'When I'm 64' -- How Aging U.S. Baby Boomers Have Begun to Carry That Weight

Excerpt: The trend toward delayed retirement could also be good news for the cognitive capacities of aging baby boomers. Cross-national data from 13 developed countries have shown a correlation between delayed retirement and the delayed onset of cognitive declines, with both delays being more characteristic of older Americans than of older Europeans.

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'I'm Sorry, Madam, Your Pension Checks Are Stopping Because You're Dead.'

Excerpt: A north Wales woman who was told her benefits were being stopped because she was dead has received an apology from pension officials.... Maria Harding ... has finally had her pension restored after a long fight to correct the mistake which was caused by a worker entering the wrong information on a computer.  MORE >>