The introduction of new pharmaceutical products drove a 9-percent increase in per-capita prescribing last year. Physicians wrote an average of 2,060 prescriptions each, according to a survey by Scott-Levin.... A study by the Center for Studying Health System Change says more than two thirds of people who obtain new coverage do so not by choice, but because of reasons involving their employers.... Another study, in JAMA, suggests that peer-reviewed, published pharmacoeconomic analyses often are seriously flawed.... Sterling Life, an Aon subsidiary, has launched the first Medicare+Choice private fee-for-service plan.... Health Net of Oregon has added chiropractic, acupuncture, naturopathy, and massage therapy to its core benefit package. Primarily, health plans sell complementary benefits as a rider.
Managed Care’s Top Ten Articles of 2016
There’s a lot more going on in health care than mergers (Aetna-Humana, Anthem-Cigna) creating huge players. Hundreds of insurers operate in 50 different states. Self-insured employers, ACA public exchanges, Medicare Advantage, and Medicaid managed care plans crowd an increasingly complex market.
They bring a different mindset. They’re willing to work in teams and focus on the sort of evidence-based medicine that can guide health care’s transformation into a system based on value. One question: How well will this new generation of data-driven MDs deal with patients?
A flood of tests have insurers ramping up prior authorization and utilization review. Information overload is a problem. As doctors struggle to keep up, health plans need to get ahead of the development of the technology in order to successfully manage genetic testing appropriately.
More companies are self-insuring—and it’s not just large employers that are striking out on their own. The percentage of employers who fully self-insure increased by 44% in 1999 to 63% in 2015. Self-insurance may give employers more control over benefit packages, and stop-loss protects them against uncapped liability.