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Western Skies MGU Programs

Traditional Medical Stop Loss


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How Western Skies MGU Lowers Trends

Despite the many advances made in healthcare transparency and improvements in efficiency, cost shifting to Private / Commercial Payers is alive and well. As the Johns Hopkins research report indicates, the Nationwide Average Charge to Cost ratio is around 3.5, with the top 50 most aggressive hospitals charging over 10 times cost.
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Specialty drugs are high-cost prescription medications used to treat complex, chronic conditions like cancer, rheumatoid arthritis and multiple sclerosis, in addition to very rare “Orphan” Diseases (i.e. “Bubble Boy” disease). Specialty drugs often require special handling (like refrigeration during shipping) and administration (such as injection or infusion).
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Nearly 20 years ago, one of the founders of the Evidence Based Medicine (EBM) discipline, David Sackett, described EBM this way: "Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.
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