Far from final words on obesity were splashed across headlines last month when the Centers for Disease Control and Prevention announced that the condition is responsible for 112,000 deaths annually in the United States. That's considerably fewer than contained in a March 2004 CDC report, now discredited, that put the number of yearly deaths from obesity at about 400,000. The newer report even suggests that overweight people (BMI of 25–29.9) might live longer than those classified as having normal weight.... Most uninsured people do not pay taxes, because they have low incomes, and would therefore not be likely to enroll in tax-free health savings accounts, according to a study by the Commonwealth Fund. However, Larry Akey, a spokesman for America's Health Insurance Plans, tells the Boston Globe that, "Our preliminary [survey] shows that roughly a third of the individuals who are buying this product were previously uninsured." This will continue to be watched closely.... To no one's surprise, General Motors blamed its largest quarterly loss in more than a decade on the increased costs of providing health care coverage for 1.1 million workers, retirees, and dependents. The company lost some $1.1 billion in the first quarter. GM officials have been complaining about health care costs for quite a while.... Every silver lining has its cloud, UnitedHealth Group learned last month. First-quarter earnings were up 41 percent but lower-than-expected growth in health plan enrollment has investors worried that we may be in for a new round of price competition.
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.