Shards of a bipartisan effort to stabilize the individual health insurance markets emerged. They focused mostly on resurrecting the ACA cost-reduction payments and giving states flexibility to come up with their own ideas, like reinsurance, for shoring up the troubled individual market.
They are all physicians. They all want to take care of people. But the chief medical officers at health plans and provider organizations often see the world through different lenses. Here, chief medical officers from both sides of the divide share their views.
Insurers are playing “small ball” and not showing leadership, says the former congressman. And some “spin-dry” inpatient providers are doing more harm than good in combating the opioid epidemic. Meanwhile, Kennedy, who chronicled his own harrowing mental health and addiction struggles in a 2015 memoir, says he has been sober for more than six years.
Annual family premiums for employer-sponsored health insurance rose an average of 3% in 2017, right in keeping with six years of relatively modest increases. Just over half (53%) of 2,137 companies offered health benefits to at least some of the workers in 2017, according to the Kaiser Family Foundation/Health Research & Trust Employer Health Benefits Survey.
Santa Barbara County officials—following the example of large employers such as Boeing and Lowe’s—decided to do a little shopping, and are offering employees incentives to receive care at less expensive, out-of-town hospitals. The savings have been impressive.
Family medicine doctors spend more than six hours interacting with electronic health records (EHRs) during a typical day, which usually lasts 11.4 hours, according to a study by the University of Wisconsin and the American Medical Association.
Infants with major birth defects accounted for 5.8% of preterm births but 24.5% of the costs incurred during infancy in 2013. The average expenditure for preterm infants with major birth defects was $226,840, compared with $42,620 for those born preterm without major birth defects.
Population health management is built on the notion that prevention, early intervention, and proactive management of chronic disease can reduce the incidence rates of costly episodes. But so far the economics are not penciling out. The cost of innovation is outstripping the financial return on investment.
Value-based care can’t be done one slice at a time, new value-based models will take aim at variations in care, the patient may gain a stronger voice, the tail could wag the dog, and value-based care will create haves and have-nots. Some predictability from the federal government would be welcome.
Oscar Health, a small insurer with big ambitions, has been enlisted to assist the storied Cleveland Clinic launch its own health plan. Each member of the plan will be matched with a care team made up of primary care provider, physician assistants, and other health care professionals.
Otezla—the generic name is apremilast—also exploited a new mechanism of action as the first inhibitor of phosphodiesterase 4 (PDE4) that results in increased expression of both anti-inflammatory proteins and reduced expression of their pro-inflammatory counterparts.