Directions and warning labels for some pharmaceuticals are starting to contain what the Wall Street Journal describes as "tailor-made ads" for patients who pick up prescriptions at the drug store. The paper reports that the number of pharmacies using such ads, so-called "health newsletters," has increased from 3,000 to 17,000 in three years.... The push for a prescription drug benefit for Medicare recipients has gotten a technological lift thanks to a new Web site that encourages consumers to send letters to Congress in support of that policy. The site, «www.fairdrugprices.org», was launched June 12 by Families USA, the National Committee to Preserve Social Security and Medicare, and the AFL-CIO.... Sleepy medical residents will begin getting some much needed shut-eye thanks to limits placed on the number of hours young doctors may work. The Accreditation Council for Graduate Medical Education, which accredits the nation's teaching hospitals, will limit the workweek for residents to 80 hours. The guideline takes effect in July 2003.
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.