MANAGED CARE April 2009. ©MediMedia USA
Private insurers who participate in Medicare Advantage have received guidelines from the Centers for Medicare and Medicaid Services that they must meet if they want to bid on Medicare insurance business this year. The guidelines protect sicker beneficiaries from discriminatory out-of-pocket charges for the health care services they need. .... Employers remain confident that employer-based health benefits will still exist 10 years from now, but their level of confidence has slipped from last year because of concern about the economy and uncertainty about potential reform, according to a report by Watson Wyatt. A survey of 489 large employers shows that 62 percent are confident that they will offer health care benefits 10 years from now, but that is down from 73 percent last year....The nation’s health insurers may be embracing the use of personal health records (PHRs), but it remains to be seen whether patients and providers will do likewise, according to a recent study conducted by the Center for Studying Health System Change (HSC). A PHR is a centralized place for people to electronically store and organize their personal health information, separate from electronic or paper medical records maintained by their providers. The HSC researchers interviewed 35 health insurance executives. Joy M. Grossman, PhD, a senior researcher at HSC and coauthor of the study, concluded that “to date, most insurers haven’t actively marketed PHRs to enrollees and physicians, and patient acceptance and physician awareness of insurer-sponsored PHRs appears to be low.”