The more doctors, exam rooms, and patients that a physician practice has, the more likely it is to adopt electronic health records, according to a report by the consulting company SK&A. The report, based on telephone interviews conducted with 237,562 medical offices, says that (to take just one of the categories) offices that see an average of 50 patients a day had a 36 percent adoption rate; those that saw more than 100 had 66 percent adoption.... Edith Rosato earlier this month was named the chief executive officer of the Academy of Managed Care Pharmacy. Rosato worked for many years at the National Association of Chain Drug Stores, and Wyeth Pharmaceuticals.... Medicare Part D is a hit. Ninety-five percent of respondents to a survey by KRC Research said that their plan works well, and nearly as many said it is easy to use. “Medicare Part D has reached popularity levels that you seldom, if ever, see from a government program,” says Mary R. Grealy, president of the Healthcare Leadership Council, a think tank.
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.