Attention all employees: Employers have a clear interest in expanding initiatives to help workers manage their personal health effectively, according to United Benefit Advisors' 2007 Employer Survey. The survey asks employers about the extent and effectiveness of their current and planned wellness and disease management programs, the range of employee benefits offered, the various employee communication strategies in place or planned, and employers' wish list for future initiatives.

The adoption of personal-health management strategies by employers of all sizes continues to increase. Roughly 25 percent of all employers currently provide various wellness and health risk assessments, and an additional 50 percent of employers would like to add such programs in the future. This is up 6 percent from last year's survey.

Interestingly, according to the survey, employers now believe that some benefits and costs should be based on an employee's involvement in managing chronic conditions. And only 17 percent believe that no financial consequences should result from differences in effort.

Does your organization currently have or plan next year to use incentives to encourage employees to take any of the following cost-control steps:

Which of the following strategies does your organization currently have in place or planned for next year?

Which of the following specific prevention and wellness programs does your organization have in place or have planned for your next plan year?

Source: United Benefit Advisors' 2007 Employer Survey

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.