News Wire
Democrats and Republicans scramble to find a response to the ruling.
The insurer uses machine learning, a sophisticated subfield of artificial intelligence, to try to decrease overdoses.
Experts in a Health Affairs blog argue that a study slated to be published in April 2019 supports the idea of letting MA and traditional Medicare compete head-to-head.
There are looming budgetary challenges, nonetheless, including increased spending for Medicaid.
FDA commissioner says new rules coming in 2020 will spur more competition and put a stop to skyrocketing prices.
2019 Year in Preview
Jan Greene
The labor market is tight (an un-employment rate of under 4%) and the Cadillac tax is still a can kicked down the road.
2019 Year in Preview
Richard Mark Kirkner
Because it enables both the security and sharing of data, blockchain seems ideally suited to health care. Next year, the pieces may come together for it to finally get some real traction in the sector.
2019 Year in Preview
Jan Greene
Scott Gottlieb, MD
We’ll see what happens to the administration’s Part B proposal. Congress is not likely to take bold action, partly because drugmakers are a strong influence on both parties. That leaves the FDA and Administrator Scott Gottlieb, MD, as major players in efforts to rein in drug prices.
CURRENT ISSUE December 2018

2019? Bring It On!

By Managed Care’s reckoning there are 10 trends you need to pay attention to in 2019. Some will come as no surprise. Yes, Medicare Advantage will continue to expand. And, yes, insurer-PBM mergers will roll on. Some may come as a bit of a surprise: Health care is poised to embrace blockchain. Bundled payments? Expect them to take off. The ACA isn’t going anywhere. Expect employers to offer more health plans. Some have to do with drugs. The massive opioid bill will not affect how insurers deal with the problem that much. High drug prices will continue to roil the waters. And marijuana is heading toward the mainstream.

It’s enough to make a clinician executive’s head spin. And we’re just talking about our cover package. We also have a story on why three start-up health plans went into the red.

Happy New Year!

Scottsdale, AZ
January 28-29, 2019
2019 Year in Preview
Frank Diamond
Which is not to say that health plans will not attempt some innovative things on their own. One such innovation: an addiction recovery medical home.
Jesse Ford
Having a payer collaboration leader is especially important for large health systems that have yet to fully consolidate revenue cycle operations following a merger or have far-flung operations in multiple states. They may vary in some details, but the same payer issues tend to crop up across a health system.
2019 Year in Preview
Timothy Kelley
CMS has broadened the services that Medicare Advantage plans can provide—services that may reduce expensive treatments and injuries. Insurers continue to see the market as a business opportunity. Critics see a slow-motion privatization of Medicare.