Microsoft has entered the consumer health care market with a free personal health record on the Web («»). HealthVault will store, collect, and distribute private health information that can be shared with a physician, a clinic, or a hospital. Information that can be shared includes what medications the individual takes and the results of blood pressure and cholesterol tests.

HealthVault will also house a search tool tailored for health queries. The personal information, Microsoft says, will be stored in a secure, encrypted database. Its privacy controls, the company says, are set entirely by the individual, including what information goes in and who gets to see it. The nonpersonal health information searches are anonymous, Microsoft says, and will not be linked to personal information in a HealthVault PHR. If a person looks for information on STDs, nobody else will know and no record of the search will be kept in the PHR.

"HealthVault could be the glue that can, we hope, bring together a person's disparate health care experiences, which can range from keeping a personal record, to talking to a doctor, getting a discharge report from a hospital and being able to keep that around, or getting an X-ray and being able to move it from specialist to specialist," says Sean Nolan, chief architect for the Microsoft Health Solutions Group. "The goal is to have all that data in one place."

When there is an interruption in a person's health coverage, such as when an employee changes jobs, "those types of events tend to disrupt a person's health care and continuity of care, so that's where HealthVault might play a part in managed care."

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.

Major health care players are determined to make health information exchanges (HIEs) work. The push toward value-based payment alone almost guarantees that HIEs will be tweaked, poked, prodded, and overhauled until they deliver on their promise. The goal: straight talk from and among tech systems.

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?

The surge of new MS treatments have been for the relapsing-remitting form of the disease. There’s hope for sufferers of a different form of MS. By homing in on CD20-positive B cells, ocrelizumab is able to knock them out and other aberrant B cells circulating in the bloodstream.

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.

Having the data is one thing. Knowing how to use it is another. Applying its computational power to the data, a company called RowdMap puts providers into high-, medium-, and low-value buckets compared with peers in their markets, using specific benchmarks to show why outliers differ from the norm.
Competition among manufacturers, industry consolidation, and capitalization on me-too drugs are cranking up generic and branded drug prices. This increase has compelled PBMs, health plan sponsors, and retail pharmacies to find novel ways to turn a profit, often at the expense of the consumer.
The development of recombinant DNA and other technologies has added a new dimension to care. These medications have revolutionized the treatment of rheumatoid arthritis and many of the other 80 or so autoimmune diseases. But they can be budget busters and have a tricky side effect profile.

Shelley Slade
Vogel, Slade & Goldstein

Hub programs have emerged as a profitable new line of business in the sales and distribution side of the pharmaceutical industry that has got more than its fair share of wheeling and dealing. But they spell trouble if they spark collusion, threaten patients, or waste federal dollars.

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.