Escalator clauses, rising prices, and why we should care

Summary: You may have asked yourself why health prices rise inexorably. Are escalator clauses, the automatic price increases common to many managed care contracts, the driving force behind trend factors? Bill Rusteberg, an independent insurance consultant in Texas, posted on his blog recently about escalator clauses, which he said commonly add 5 percent a year to […]

Escalator clauses examined as an underlying factor: Risk Managers

Filed Under: Costs

Summary: “Are escalator clauses, common to most Managed Care Contracts, the driving force behind trend factors?” Bill Rusteberg writes over at, his blog. Bill’s a broker in Texas, and a man with an encyclopedic knowledge of health care. “An actuary’s primer I stumbled upon while reading incredibly boring stuff (my answer to sleeping pills) […]

Have PPO Networks Perpetrated The Greatest Heist In American History?

Summary: “Trillions have been redistributed from the American workforce to the health care industry, creating an economic depression for the middle class,” Dave Chase writes over on Forbes, introducing a lengthy interview with multiple quotes from my acquaintances Bill Rusteberg and Mike Dendy, who featured in this post I wrote three years ago. “The Washington […]

New models of payment: Cutting out the insurer, or can I have a lower price for that?

This is the third part in our series of new models of payment in the health-care marketplace, touching employers and individuals. The first part is here, and the second part is here. * * * * * We’ve been writing about new models of payment for health care by employers. So individuals might ask: How does […]

New models of payment: Going direct, and cutting out the middleman

  This is the second part in our series of new models of payment in the health-care marketplace, touching employers and individuals. The first part is here. * * * * * Employers, patients and other health-care marketplace parties are increasingly cutting insurance companies out of the equation. We’ve written about cost-plus and Medicare-plus, which […]

A wave of change in insurance payment models: Cost-plus, not bills

Filed Under: Costs, Health plans, Patients

Mike Dendy, Woody Waters, Jeff McPeters and Bill Rusteberg may be the biggest looming nightmare of the insurance industry and the hospital billing department. But they don’t see it that way: They see themselves as a solution to a problem. The three are among the growing ecosystem of practitioners of “cost plus” or “Medicare plus” […]