Consumer Cost Sharing in Private Health Insurance: On the Threshold of Change

Employers are asking employees to pay more for health care through higher premium contributions, share of contribution, and out-of-pocket maximums, along with variations in deductibles, copays, and coinsurance based on choice of providers, networks, drugs, and other services. This issue brief examines consumer cost-sharing trends in private insurance, discusses the outlook for cost sharing in employment-based benefits, and considers public policies to support health care markets for consumers

Pharmacy Benefits: New Concepts in Plan Design

This issue brief examines changes to prescription drug benefit coverage in large-employer plans and implications for a Medicare prescription drug benefit. The brief discusses reasons behind employer benefit plan redesign and recent coverage trends, as well as potential paths to modernize benefits

Pharmacy Benefit Managers: A Model for Medicare?

This issue brief uses large-employer experiences with pharmacy benefit managers (PBMs) to shed light on their potential as Medicare outpatient drug benefit administrators. PBM management techniques are discussed, as well as employer perspectives on PBM strengths and weaknesses and lessons learned. Considerations for Medicare policy are also examined. The brief built on a previous NHPF issue brief entitled The ABCs of PBMs

Depression: A Decade of Progress, More to Do

This issue brief discusses the most recent findings on depression prevalence and cost; examines trends in outpatient treatment, including the dramatic growth in antidepressant use; discusses efforts to improve treatment in primary care; and explores possible public policy avenues for improving treatment access and quality

Beyond Lawyer Assistance Programs: Applying the United States Marine Corps\u27 Concepts and Principles of Spiritual Fitness as a Means Towards Increasing the Health, Resiliency, and Well-Being of Lawyers—While Restoring the Soul of the Profession

(Excerpt) Lawyer Assistance Programs (“LAPs”) are recognized as an invaluable tool for increasing well-being by assisting lawyers to secure confidential treatment in order to overcome various addictions and mental health issues. The 2017 report by the National Task Force on Lawyer Well-Being underscores this notion by asserting that LAPs “play a pivotal role in lawyer wellbeing.” While this is true, the legal profession would do well to look beyond LAPs and broaden its discussion regarding wellness. In particular, the American Bar Association (“ABA”) should more robustly recognize and encourage spirituality as a means towards health, resiliency, and well-being, much like the United States Marine Corps (“USMC”) has done. Spirituality, as viewed by the USMC, is another valuable resource, among others, that is an important means to increase the health and resiliency of its members. Indeed, spiritual fitness is prominently referenced and has its own section in the official website of the USMC maintained by Headquarters Marine Corps. Along with this, General Robert B. Neller, then Commandant of the USMC, recognizing the importance of spiritual fitness in a 2016 ALMAR message to all Marines, stated that “[r]esearch indicates that spiritual fitness plays a key role in resiliency, in our ability to grow, develop, recover, heal, and adapt. Regardless of individual philosophy or beliefs, spiritual well-being makes us better warriors and people of character capable of making good choices on and off duty.” Setting aside the significant differences in the demands, work, and lifestyles of Marines as warriors compared to that of lawyers as white-collar professionals, there are enough similarities between the professions as they relate to wellness to link the concept of spirituality as a means towards increasing well-being among lawyers. For example, both professions often involve great difficulties and test the breaking point of its members; additionally, both professions often involve highly stressful work with long hours, considerable responsibility, and the need for excellence and results-generated productivity. Perhaps most importantly, both professions often involve weighty responsibilities and heavy burdens that entail enormous consequences and impact on other people. Certainly, the stress associated with these factors does not, in and of itself, cause addiction or mental health issues. But it undoubtedly often serves as a catalyst or trigger in some individuals for addictive behavior or certain mental health conditions, such as depression, which can spiral into destructive behavior or poor life choices