Many employees struggle with basic health benefit terms, a Watson Wyatt Survey finds. The top challenge for 43 percent of workers is understanding what their health care plan covers. Less than half are comfortable explaining common benefit terms, such as copayment and deductible, to friend or coworker.... Old matches new when it comes to oral diabetes drugs. A study in the Annals of Internal Medicine indicates that older, cheaper drugs are as safe and effective as newer ones. The report, "Comparative Effectiveness and Safety of Oral Diabetes Medications for Adults with Type 2 Diabetes," is from the Agency for Healthcare Research and Quality's Effective Health Care program.
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.