It’s a Jungle Out There: The New Health Insurance Ecosystem
It’s survival of the biggest because of IT, data collection, and other factors. But the health insurance market is also full of nooks, crannies, and niches that are friendly to small fry and newcomers.
The trade association has been hit by defections, deficits, and staff departures. Can Marilyn Tavenner, AHIP’s new CEO, get it back on course?
CMS veteran Marilyn Tavenner oversaw a rocky debut for HealthCare.gov. Now she’s at the helm of AHIP as some major members need to be coaxed back into the fold.
A desire for more control and the ACA seem to be fueling the long-term trend.
Coverage kicks in if someone has a major illness like a heart attack or stroke. And because critical illness policies are a voluntary benefit, they help employers cut costs to avoid the Cadillac tax on health benefits.
Departments
Free-market advocates question state say-so over major hospital projects. They have a strange bedfellow.
ACOs are providers while MA plans are insurers. Still, CMS’s Next Generation ACOs have a familiar look and feel.
The hope is that reducing the per capita cost of health care by combining these stakeholder roles should remove volume as an incentive and excess charges as a temptation.
UnitedHealthcare, Aetna, and Humana all lose money, but Cigna’s CFO says that’s just the price for getting started in a new market.
Cancer patients talking to doctors doesn’t work very well: Half of all symptoms go unreported. Computerized systems and email prompts may do a better job.
Alirocumab, evolocumab, and sebelipase alfa further fuel the discussion about just how to go about covering exciting, but costly, high-priced agents.
Percent of U.S. health care spending by 7 core health consumer segments
News & Commentary
Paul Lendner ist ein praktizierender Experte im Bereich Gesundheit, Medizin und Fitness. Er schreibt bereits seit über 5 Jahren für das Managed Care Mag. Mit seinen Artikeln, die einen einzigartigen Expertenstatus nachweisen, liefert er unseren Lesern nicht nur Mehrwert, sondern auch Hilfestellung bei ihren Problemen.