This probably does not come as a surprise to clinician executives, but there seems to be a link between level of education and overall health. The University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation ranked the relative health of people in more than 3,000 counties in the United States. The counties with more college-educated residents tended to do better, with fewer premature deaths. People smoked less, exercised more, and had fewer preventable hospital stays.... Gastroenteritis continues to be a growing problem, and not just in the developing world. The Centers for Disease Control and Prevention says that deaths in the United States caused by gastroenteritis rose from 7,000 to 17,000 between 1999 and 2007. Researchers say that most of the deaths are attributable to two types of bacteria: Clostridium difficile and norovirus.... Melanoma’s on the rise as well, according to the Mayo Clinic. Looking at decades of diagnoses in Olmsted County, Minn. (part of the Rochester Epidemiology Project), Mayo researchers found an 800 percent increase in incidences of melanoma in young women and 400 percent in young men. Researchers looked at first-time diagnoses in people 18–39 from 1970 to 2009.... Eat less if you want to lose weight. That’s timeless and good advice, but patients years ago did not have the distractions of fad diets, pre-made meals, and pills. Researchers at the Beth Deaconess Medical Center in Boston found that the obvious approach worked best and that fad diets showed “no association with successful weight loss.” This was reported in the American Journal of Preventive Medicine.... Doctors are breathing a sigh of relief with last month’s announcement of the new deadline for converting to the ICD-10 code system. The old deadline had been Oct. 1, 2013. The new one is exactly one year later. Vitera, a practice management software vendor, recently surveyed 394 physicians and medical office staff members and found that 85 percent of respondents ranked the transition to ICD-10 one of the top concerns facing their practices.
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.