No great surprise here: The group Physicians for a National Health Program has come out saying that the federal government should become the single payer for health coverage in the United States. What is surprising to some is that the group put forth its proposal, which is essentially an upgraded and expanded version of Medicare, in the "generally conservative" Journal of the American Medical Association. According to the Christian Science Monitor, that puts "the idea back on the map as a serious alternative".... Employers are using financial incentives and deterrents more often in their attempt to keep workers healthy and costs down, according to a new Hewitt Associates study. Use of financial incentives/deterrents rose from 32 percent to 40 percent from 1995 to 2002 among major U.S. employers.
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.