A survey of 500 HSA enrollees finds that 82 percent are satisfied with their accounts and 91 percent believe such accounts should remain an option for Americans. More than 80 percent of respondents cite their ability to save for future health care expenses as the primary reason for opening and depositing money into their HSAs. The survey was conducted by OptumHealth, a health and wellness company that is part of the UnitedHealth Group.... Americans are still having trouble keeping their diabetes under control, according to the 2008 Agency for Healthcare Research and Quality National Healthcare Disparities Report. Only slightly more than half of the 18 million Americans diagnosed with diabetes had their blood sugar, cholesterol, and blood pressure under optimum control. Diabetes is the sixth leading cause of death in the United States, with $116 billion spent on medical care for people with the disease. What’s scarier is that the report also says another 6 million Americans may have diabetes and don’t know it.... Employers now foresee an increase of 7.4 percent in health benefit costs in 2009. Health benefit costs had risen by about 6 percent annually for four consecutive years and employers had expected a similar increase for 2009, according to a study conducted by Mercer. Nearly half of all respondents say that they will be making more cost-saving changes than usual to their current health plans because of the economic downturn and that they don’t see “simple cost shifting as the silver bullet this time around,” says Linda Havlin, a consultant in Mercer’s health and benefits business. The survey reports that 22 percent of employers are considering a consumer-directed health plan.

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.

Major health care players are determined to make health information exchanges (HIEs) work. The push toward value-based payment alone almost guarantees that HIEs will be tweaked, poked, prodded, and overhauled until they deliver on their promise. The goal: straight talk from and among tech systems.

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?

The surge of new MS treatments have been for the relapsing-remitting form of the disease. There’s hope for sufferers of a different form of MS. By homing in on CD20-positive B cells, ocrelizumab is able to knock them out and other aberrant B cells circulating in the bloodstream.

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.

Having the data is one thing. Knowing how to use it is another. Applying its computational power to the data, a company called RowdMap puts providers into high-, medium-, and low-value buckets compared with peers in their markets, using specific benchmarks to show why outliers differ from the norm.
Competition among manufacturers, industry consolidation, and capitalization on me-too drugs are cranking up generic and branded drug prices. This increase has compelled PBMs, health plan sponsors, and retail pharmacies to find novel ways to turn a profit, often at the expense of the consumer.
The development of recombinant DNA and other technologies has added a new dimension to care. These medications have revolutionized the treatment of rheumatoid arthritis and many of the other 80 or so autoimmune diseases. But they can be budget busters and have a tricky side effect profile.

Shelley Slade
Vogel, Slade & Goldstein

Hub programs have emerged as a profitable new line of business in the sales and distribution side of the pharmaceutical industry that has got more than its fair share of wheeling and dealing. But they spell trouble if they spark collusion, threaten patients, or waste federal dollars.

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.