During kidney dialysis, osmosis helps remove waste products from the blood while retaining essential substances. After a recent governmental effort to increase transparency in the health care space, health care costs for employers and employees is also undergoing a form of osmosis throughout the commercially insured population. 

Significant policy action over the last four years arising from government entities like the Centers for Medicare and Medicaid Services, the Department of Labor, the Department of Treasury, and the Department of Justice has focused on cost-containment and wasteful spending. These efforts include the Hospital Transparency Rule, sub-components of the Consolidated Appropriations Act of 2021, the Transparency in Coverage Rule, the establishment of the Task Force on Health Care Monopolies and Collusion, and the publication of the Healthy Competition website by the Antitrust Division of the Department of Justice, and each is aimed at helping ensure access to fair and competitive health care markets for patients. 

This work to remove wasteful spending has also slowly been seeping into the consciousness of employers and their employees. There have been three notable ERISA cases over the last year, including Peters v Aetna and OptumHealth, Lewandoski v Johnson and Johnson, and S.M.O v Mayo Clinic and Medica Health Plan Solutions. Each case points to the fiduciary lens that has been placed upon plan sponsors as a result of the Consolidated Appropriations Act of 2021.