Worried about implementing electronic health records? The Guide to Reducing Unintended Consequences of Electronic Health Records may be just what’s needed. Developed by Rand, it’s designed to help organizations anticipate, avoid, and address problems that can occur when implementing and using an electronic health record.… The number of underinsured adults — those with health insurance all year, but also with very high medical expenses relative to their incomes — rose by 80 percent between 2003 and 2010, from 16 million to 29 million, according to a new Commonwealth Fund study published in September’s Health Affairs. Forty-four percent of U.S. adults — 81 million people — were either underinsured or uninsured in 2010, up from 75 million in 2007 and 61 million in 2003…. Men have a higher rate of advanced tumors compared to women in all age groups examined, suggesting that the age that people should undergo an initial screening colonoscopy should be sex-specific. Although some studies have shown that men are at greater age-specific risk for advanced colorectal neoplasia than women, the age for referring patients to screening colonoscopy for colorectal cancer (CRC) in average-risk patients is 50 years for both men and women because of the increase in the prevalence of CRC in the sixth decade of life.
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.