Many jobs available to young adults pay little and do not include health benefits. Those are two reasons cited to explain why 13 million young adults lacked coverage in 2003. That's 2.2 million more than those who lacked coverage in 2000, according to a study by the Commonwealth Fund. Those 19–29 years old who come from low-income families are especially likely to lack coverage.... Prescription medications are getting more difficult to afford, according to a study by the Center for Studying Health System Change. A bigger percentage of those with chronic medical problems could not purchase the prescription medications that they needed in 2003 than could do so in 2001, according to the HSC's Community Tracking Study Household Survey. The authors say that 18.3 percent of adults 18 and older with chronic medical conditions had problems buying medications in 2003. It was 16.5 percent in 2001.
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.