Workers aren’t nearly as healthy as they think they are, says a study sponsored by the National Business Group on Health. Nearly 90 percent think they are in good shape. The reality is that more than half of survey respondents are overweight or obese. In addition, employees severely underestimate how much of their health care costs are covered by their employers.... The FDA approved more drugs in 2012 than it had in any year since 1996. It approved 39 new medications and biological products, up from 30 in 2011 and 21 in 2010. Pharmaceutical companies, still feeling the effects of many drugs switching to generic status, of course welcome this development.
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.