The anthrax scare has led to a major consolidation of communication, legislative, and public affairs offices in the Department of Health and Human Services. The Washington Post reports that HHS Secretary Tommy Thompson was upset that information disseminated during terrorist mail attacks was often muddled and contradictory.... In what's being touted as an unprecedented effort, doctors and hospitals in California will be rewarded with bonuses of at least 5 percent for quality under a common set of standards adopted by six HMOs. They are: Aetna U.S. Healthcare, Blue Cross of California, Blue Shield of California, Cigna, Health Net, and PacifiCare.... Most Americans are happy with their health plans, according to a recent Harris Poll. In a survey of 927 adults, 67 percent of those with employer-provided plans graded those plans A or B, while only 8 percent gave them a D or F.... Employers, however, seem less enthusiastic — at least when it comes to prevention efforts by HMOs. A report by Hewitt Associates says that they've decided to do something about it. The report finds that 93 percent of large companies offered some kind of health promotion program in 1999, up from 88 percent in 1994.
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.