You bet they do. Are they fulfilling that role? You bet they do not. The Centers for Disease Control and Prevention calls this the world’s most pressing public health threat. Insurers’ track record in ensuring proper use of antibiotics has been abysmal. Improvement is possible, and necessary.
Fostering appropriate use of antibiotics is one step, but there’s much more that insurers can do, starting with eliminating health care-associated infections in the first place. Hand washing works in stopping the spread of infection. How many health plans track how well hospitals enforce hand-hygiene rules?
In these early days everything is in flux, but accountable care organizations (ACOs) will need to manage pharmacy in order to help reduce the big-ticket episodes of care. A lot will depend on whether the risk for medical and pharmacy spending remain separate. Some experts see that as unsustainable.
Opponents say that the new rules would reduce consumer choice and industry competition
Independence Blue Cross and Aetna are two insurers that have opened special centers dedicated to finding better ways to deliver care
Their cost advantage is incontrovertible, but will doctors and patients join reference product manufacturers in trying to restrict them?
Robert Royce, PhD
Average ED income per patient in one hospital was $184
Pill hoarders, doctor shoppers, and just plain addicted patients are a growing problem for physicians — and thus for health plans, too
Both payers and providers benefit
Adasuve helps people with bipolar disease or schizophrenia recover from an intense state of agitation