Action Briefs


Action Briefs

Members have access to a variety of comprehensive action briefs at no cost. Each action brief provides a business case scenario for employers to take action on the most up-to-date topics that are critical in achieving seamless outcomes. Use the briefs to evaluate and enhance your current offerings or for guidance on beginning a new initiative.

  • Fertility

    Fertility and Family Building Benefits

    There is growing recognition of the desire for comprehensive fertility and family building benefits for modern workforces as many employees are starting families later in life and families of all compositions are looking to grow. The prevalence of infertility has increased and does not discriminate – it affects all people equally, regardless of gender, geography, or socioeconomic status. Globally, 1 in 6 are impacted. As a result, employee sentiment and desires for fertility and family building benefits have shifted – and are impacting employers’ talent recruitment and retention strategies.

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  • Ketamine

    Ketamine-Assisted Therapy for Treatment-Resistant Depression

    Major depressive disorder (MDD) and treatment-resistant depression (TRD) are expensive problems for employers. A sizeable number of working adults suffer from MDD, which impacts their quality of life and their work productivity. Standard workplace mental health support comprises disease management programs, EAPs and behavioral managed health organizations. However, these solutions may not be adequate to support individuals suffering from TRD. Ketamine-Assisted Therapy (KAT) is currently being utilized as a legal treatment for TRD; research continues to explore the efficacy of KAT when other treatments have failed.

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  • Vaccine

    Why Should Employers Care About Improving Employee Vaccination Rates

    Vaccination rates among children and adults for some preventable diseases remain suboptimal. Employers can reduce this threat to employee health by taking steps to improve confidence in and use of vaccines as a safe and effective way to prevent diseases. Employers must consider the many factors that can influence vaccination confidence – both positively and negatively – as decisions to obtain a vaccination can be influenced by family, peers, community, culture and politics. Effective plan design strategies, targeted communications and helpful resources can assist employers in developing and implementing a successful plan.

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  • Biomarkers

    Biomarker Testing: What Is It & Why Should Employers Invest In It?

    Biomarker tests help employers control costs by eliminating trial-and error prescribing and subsequent exposure of patients to medications that may be ineffective and have harmful side effects. These tests are based on substances found in blood, bodily fluid or tissue and serve as a measurable way of predicting how a patient will to respond to treatment. Biomarker testing is an important tool of precision medicine that ensures patients get the treatment most likely to work for them, while minimizing costs due to ineffective treatments.

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  • Biosimilars

    Biosimilars: Stories from the Real World

    As the pipeline for biologic drugs continues to flow, employers are looking to biosimilars for help in controlling the ever-increasing financial burden on employee benefits. Biosimilars are considered “highly similar” to FDA-approved biologic originator drugs, with no clinically meaningful differences in terms of safety, purity and potency. Currently, over 80% of biosimilars run through the medical claims side. Employers need to require that clinical protocols are clearly defined in carrier contracts and mandate the appropriate use of biosimilars for patient efficacy and cost effective outcomes. Biosimilars can reduce pharmacy benefit costs significantly, just as generic drugs have done.

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  • Congress

    CAA Plan Sponsor Obligations for PBMs

    At MBGH's 2022 Employer Forum on Pharmacy Benefits & Specialty Drugs our keynote speaker, Jonathan E. Levitt, Esq from Frier Levitt, discussed Plan Sponsors’ fiduciary obligations under the Consolidated Appropriations Act (CAA). He graciously agreed to provide a draft communication for employers to send to their contracted PBM to request the data elements required under the CAA. The deadline for employers to submit this data to the federal government is December 27, 2022.

    *Please note that grandfathered Plans are not subject to the CAA requirements*

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  • Surgery

    Are Payment Practices Leading to Unintentional
    Opioid Use?

    The surgical setting introduces many patients to opioids. While opioids are inexpensive, they come at a cost. Estimates suggest that greater than 2 million surgical patients become persistent opioid users each year, costing society more than $13 billion annually. Despite their widespread use, 72% to 88% of patients still report moderate-to-severe pain in the first 72 hours after surgery. Non-opioid post-operative pain medications, administered directly into the surgical site, have proven highly effective in managing post-surgical pain and greatly reduce the need for opioids. Employers play a pivotal role in making these new alternatives available to their members.

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  • PDTs

    Prescription Digital
    Therapeutics (PDTs)

    As part of today’s new frontiers in digital health, PDTs are a new therapeutic class that uses software as medicine. PDTs offer patients additional avenues to overcome treatment access barriers that are often associated with medications or in-person therapy. They are defined by their clinical efficacy and FDA market authorization and have the ability to diagnose, prevent, manage or treat a medical condition on its own (or in combination with medications, devices or other treatments to optimize patient care). Employer benefits include the opportunity to deliver safe, noninvasive, non-drug and cost-effective solutions to support employees and members.

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  • obesity action brief

    Obesity Management

    Obesity is recognized by the CDC, AMA and the FDA as a multi-faceted chronic disease requiring long-term management. It is a complex condition affecting more than 31% of full-time employees - another 37% in the workforce are overweight. The good news is that even a small amount of weight loss (5% of a person’s total body weight) can have a clinically meaningful impact on many obesity-related comorbidities and complications, leading to health care cost savings and improved health. Use these briefs to help tackle the obesity epidemic at your organization and support your members in their weight loss journey.

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    Non-Alcoholic Fatty Liver Disease

    Liver disease is a silent epidemic that affects millions of Americans and imposes a significant financial burden on employers. As a matter of fact, 22% of Americans have non-alcoholic fatty liver disease (NAFLD) and for those with obesity, 80-90% are affected. Because there often are no symptoms, NAFLD can progress to cirrhosis and liver failure with few warning signs. The good news is that early detection and lifestyle modification can reduce the progression of this disease. Employers should be aware of new testing options and treatments to mitigate the high cost of treating advanced liver disease.

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  • clbp

    Chronic Low Back Pain

    As one of the top three most costly conditions in the U.S., chronic low back pain (CLBP) is a significant burden to employers not only due to health care costs but disability and productivity impacts. Did you know that fewer than half of those disabled due to CLBP for longer than six months return to work and after two years, the return-to-work rate is close to zero? This action brief outlines the pros and cons of the many different CLBP treatment options available and provides detailed action steps employers can take to proactively manage this condition, improve outcomes and impact the total cost of care.

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  • insulin

    State Legislative Impact
    on the Cost of Insulin

    Affordability of insulin directly impacts the adherence and health status of those living with diabetes that require insulin. Many states have implemented legislation for maximum copays on the cost of insulin to address this issue. State legislation only impacts state-regulated health plans. Self-insured employers can set their own coverage limits to make this life-saving medicine affordable. This action brief offers best practices for High Deductible Health Plans (HDHP), brings insight into what MBGH employers are saying and provides employer action steps.

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  • hemo

    & Bleeding Disorders

    This brief provides resources to more effectively manage the high cost of hemophilia and improve the lives of those impacted by this rare but serious disease. Vetted by health benefit professionals from employer member companies, this resource is available to employers across the country to help them: Better understand hemophilia prevalence and related cost; Identify how benefit plan design can support (or hinder) best in class treatments; and Understand the steps to take with vendors to improve overall quality of care and reduce waste.

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  • pharmacy

    Precision Medicine in
    Pharmacy Design

    Pharmacogenomics, Precision Medicine, Pharmacogenetics, human genome and genetic testing have become frequent terms that benefit leaders and consultants use as they design their benefit offerings, particularly with pharmacy benefits. Given that cost and quality care are top of mind for employers today, it is essential that adequate access and plan design features are in place to both ensure members have access and to control costs. This brief explores how these terms characterize ways an individual's genes affect their response to medications and how they are being used specifically within the pharmacy benefit for self-insured employers.

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  • biosimilars

    Transforming Pharmacy Benefits:
    Role of Biosimilars

    Costs continue to escalate year over year which creates a significant burden on employers. Strategies that mitigate risk, such as member education around plan cost difference, product switching by providers and innovative benefit coverage, are more important than ever. If employers are serious about driving down costs, while ensuring their members have access to therapies that treat complex chronic, life threatening and rare medical conditions, this is the time to act on the use of biosimilars.

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  • Diabetes.png

    Considering Authorized Generics

    In collaboration, the Mid-American Coalition on Healthcare (MACHC) and the Midwest Business Group on Health (MBGH) publish this report to bring cost management strategies to employers to help as they manage pharmacy benefits. The brief examines authorized generics as a class of drugs, their impact on the marketplace and provide guidance to employers to help ensure AGs are covered under the pharmacy benefit. To control spending, employers should discuss AG coverage with their Pharmacy Benefit Manager or Pharmacy Benefit Administrator (PBM or PBA).

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  • insulin

    Insulin Access and Affordability

    Diabetes impacts more than 34 million people in the US. This chronic disease is a result of how the body processes glucose. When it goes untreated or is not treated properly it can lead to many other co-morbid diseases and illnesses. Today, between 10% - 20% of people with type 2 diabetes need insulin to control their blood sugar. However, all people with type 1 diabetes require insulin every day to survive – it is a matter of life or death. Cost and access are the biggest barriers for those in need of insulin. This brief shows employers ways they can alleviate access and cost for this important medication for those who require it.

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  • diabetes

    Why Employers Shouldn't Ignore Diabetes

    Employers cannot afford to wait to address the costly disease of Diabetes. By 2030, the total cost of diabetes is predicted to be $622 billion – a 53% increase from today. With stakeholders working together, we can change the face of this disease. This brief shows employers the costs of the disease and how to address them.

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