Health insurance premiums rose an average of 6.1 percent in 2007, less than the increase reported last year, but more than the increase in workers' wages or the inflation rate, according to a report by the Kaiser Family Foundation and Health Research and Educational Trust. The increase this year was the slowest rate of premium growth since 1999, when premiums rose 5.3 percent. Since 2001, premiums for family coverage have increased 78 percent, while wages have gone up 19 percent and inflation has gone up 17 percent.... Employers are backing the development of Web-based health records, according to an article in the Wall Street Journal. Intel, Wal-Mart, and six other employers are banding together to fund the Children's Hospital Informatics Program. The program will develop electronic health records and include storage and updating capabilities.... Commercial health plans posted improvements in 30 of 44 quality of care measures, including important gains in childhood immunizations and colorectal cancer screening, according to the NCQA in "The State of Health Care Quality 2007" report. Medicare managed care plans improved in only 7 of 21 measures of care. However, in 2006, 44 new Medicare managed care plans reported on quality for the first time, bringing the total to 211 publicly reporting plans this year. Stay tuned for details next month.
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.