"Problem recognition" is what Cigna appears to be going through, as the company's stock continues to fall and analysts predict that a turnaround may take longer than originally hoped. "The company is still getting to the bottom of how bad the problems really are, and we remain unsure as to when that bottom will be reached," Matthew Borsch, an analyst with Goldman Sachs, tells the Hartford Courant.... Draconian measures are being taken by some companies who wish to reduce health care expenditures. The Wall Street Journal reports that many businesses are firing employees with disabilities to reduce costs. These workers could be considered casualties of mergers. For instance, the paper reports that Polaroid last July fired 180 disabled employees, terminating their health insurance in the process, as the company prepared to sell assets to Bank One.
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.