I-Spy 2 is a new private-public collaboration that combines personalized medicine and novel clinical trial design to develop lifesaving new breast cancer drugs. It’s a partnership between heavy-hitters like the Food and Drug Administration, the National Institutes, and major pharmaceutical companies, and is led by the Foundation for the National Institutes of Health.... About 66 percent of the nearly 20 million state and local government employees were enrolled in employer-sponsored health plans in 2008, according to the Agency for Healthcare Research and Quality. In comparison, only 54 percent of private-sector workers were enrolled in their employers’ health plans.... A Swiss study suggests that implementing antibiotic treatment guidelines to treat infections that commonly occur in hospitals can change prescription practices and increase the appropriate use of antibiotics. The authors suggest that judicious use of antibiotics is essential, considering the growth of antimicrobial resistance and escalating costs in health care.
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.