Managed Care

2019 Year in Preview
Richard Mark Kirkner
Because it enables both the security and sharing of data, blockchain seems ideally suited to health care. Next year, the pieces may come together for it to finally get some real traction in the sector.
Editor’s Memo
Peter Wehrwein
Starting in 2015, we’ve used our December issues to feature a collection of “Year in Preview” stories—or YIPs as we’ve come to call them. Turns out we’re also susceptible to the contagion of acronyms that infects American health care. The goal with the YIPs is to take a step back, look…
Neil Minkoff, MD
Not long ago, I was involved in a pair of projects to determine real-world outcomes. It didn’t take long to figure out that EHR and claims data are insufficient for measuring the patient experience. For example, rheumatologists don’t always know when their patients with gout have a flare because…
Editor’s Memo
Peter Wehrwein
Last year, the politics of health insurance were all about repealing and replacing the ACA. Maybe it made sense from a political perspective for Republicans to go after the signature domestic achievement of the Obama administration. But in the bigger picture the antipathy is hard to figure. “Obamacare”…
Letter to the Editor
Gene Farber, COO, Reliance ACO: “Reliance ACO is a Track 1 that started in 2014. We have saved CMS over $32 million and have received money back in two of the four years…. I want to scream when anyone, including Seema Verma, says we are not at risk.” There’s more.
Managing Editor’s Memo
Frank Diamond
This issue we look at the roles that nurses and nurse practitioners play. (And let’s quickly add that both men and women populate the professions—though the majority of both are still overwhelmingly female.) Nurse practitioners are especially on the managed care radar screen because health plans…
Editor’s Memo
Peter Wehrwein
Addressing the social determinants of health has become fashionable in American health care, which loves a hot trend almost as much as it does new technology or promises to rein in spending. The ambition makes sense: Move upstream (and out of the office and away from the hospital) to where the causes…
News & Commentary
Eighty-two percent of employees think that having a high-deductible health plan helps them make better decisions about health care, according to a survey by Clear Insights, a publication for investment and accounting professionals. In addition, three quarters of employees who purchased an HDHP were…