Men carry a higher average account balance ($1,525) in their health savings accounts and health reimbursement accounts compared to women ($1,321), says the Employee Benefit Research Institute’s “Health Savings Accounts and Health Reimbursement Arrangements: Assets, Account Balances, and Rollovers, 2006–2010.” EBRI attributes this to the fact that men use less health care than women, allowing them to maintain higher account balances.… More than 25 percent of women diagnosed with early ovarian cancer do not receive lymph node biopsies — disheartening because lymph node biopsies can lead to improved survival, say researchers at the University of California–Davis Cancer Center and the California Cancer Registry. They found that 72 percent of patients with early-stage disease had diseased lymph nodes in the pelvis and abdomen. Five-year survival for women who had a node biopsy was 84 percent, compared with only 69 percent of those who did not have the tests. Findings were published in the journal Gynecology Oncology.… The percentage of adults 45 years and older who use a statin to control their cholesterol increased from 2 percent in 1988–1994 to 25 percent in 2005–2008 according to “Health, United States, 2010,” a report prepared by the Centers for Disease Control and Prevention’s National Center for Health Statistics. Half of men ages 65–74 had taken a statin drug in 2005–2008, compared with over one third of women in the same age group.
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.