When it comes to controlling rising health care costs, consumers think the responsibility rests squarely on health insurance companies' shoulders. About 94 percent of consumers surveyed by Great-West Healthcare, a national provider of employee benefits, say that insurers are "extremely" (62 percent) or "somewhat" (32 percent) responsible for controlling costs. In contrast, one in five consumers says that the individual is extremely responsible. Employers also get some of the responsibility pie — 51 percent of consumers say employers are "somewhat" responsible and 13 percent report that employers are "extremely" responsible.
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.