The National Committee for Quality Assurance and the Joint Commission on Accreditation of Healthcare Organizations are considering working together to develop a HIPAA privacy certification program. The program would target companies such as information technology vendors, practice management companies, and disease management organizations. The accrediting bodies hope to reach final agreement on the program in the next several weeks.... The nation's second-largest hospital chain, Tenet Healthcare, hopes to cut costs by $100 million, in part by selling or consolidating 14 hospitals in eight states. Tenet wants to use the proceeds to buy back shares, improve efficiency, and boost profit margins.
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.