Many young adults are choosing not to purchase health insurance, according to the Census Bureau. Some 16 million people between 18 and 34 find the costs prohibitive. Choice is not the only issue; many work in businesses that do not offer insurance. Those who have lost their jobs find COBRA too expensive as well.... Baby boomers won't put as much strain on the health care system as originally feared, according to a new report by AARP. Thanks to improved socioeconomic conditions and better education, disability rates for that generation will not go up as much as they had for previous generations. The baby boomer demand for long-term care services is 20 to 30 years off.... A new accreditation program will seek to guard the rights and safety of participants in clinical trials. The Partnership for Human Research Protection is a joint effort of the National Committee for Quality Assurance and the Joint Commission on Accreditation of Healthcare Organizations. The standards will be made final in April and reviews will then begin.
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.