News Wire
Recent scandals about authors’ failure to report conflict of interests called a systemic problem.
Opinion piece tries to persuade more patients to partner with the health care team taking care of them.
Survey finds that 97% of family physicians believe that patients visit them armed with erroneous info pulled from the web.
Rules would allow states to request permission to subsidize health plans that do not comply with ACA coverage requirements.
GOP legislators push bills that would keep work requirements for some Medicaid recipients in place and maintain the state’s role in trying to overturn the ACA.
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.
2019 Year in Preview
Michael D. Dalzell
BPCI Advanced signals a willingness among Medicare providers to redesign care and take on risk. Commercial payers are watching closely.
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
Richard Mark Kirkner
In the midterms, Republicans tried to walk back their opposition to guaranteed issue, while health care worked as an issue for Democrats.
2019 Year in Preview
Robert Calandra
Insurers are figuring out the market, say the law’s defenders.
Petra Esseling
Despite high need and urgency, patient adherence is low. One might think that puts the onus on patients, but a major reason for this gloomy picture is the severe shortage of mental health professionals across the country—a shortage that’s only going to increase.