National Integrative Health

NIH White Paper Brief

The Medical Rx Cost Center

Infusions, Injectables, Biosimilars, and Every J- and Q-Code

Why the biggest drug costs in a self-funded plan hide on the medical claim, and what employers can do about it before the next renewal

By Jake Velie, CPT

Founder, Chairman & CEO, National Integrative Health

Cover of the National Integrative Health NIH White Paper Brief, The Medical Rx Cost Center

Access the Medical Rx Cost Center Brief

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What You'll Learn

Inside this brief

WHERE THE SPEND HIDES

Why Medical Rx costs sit in the medical claim, out of view—and what Medical Rx covers: infusions, injectables, biosimilars, J- and Q-codes.

SITE OF CARE AND THE STOP-LOSS CONNECTION

Same drug, different chair or a different contract—and how overpaid claims follow you to renewal.

FIVE STEPS AND RENEWAL QUESTIONS

A practical review process for executives, plus what to ask your broker and partners.

Developed for the stakeholders responsible for plan spend

For plan sponsors, brokers, TPAs, and stop-loss partners. Educational content; not legal or clinical advice.

View the Full Brief