The unfortunate distinction of being the state with the highest number of obese adults goes to Mississippi. According to a study by Trust for America’s Health and the Robert Wood Johnson Foundation, 35 percent of Mississippi’s adults are obese. “Obesity has contributed to a stunning rise in chronic disease rates and health care costs,” says Jeffrey Levy, executive director of the Trust for America’s Health. Colorado, at 21 percent, has the lowest obesity rate.... Electronic health record system vendors aren’t leaving behind a healthy ratio of satisfied to dissatisfied providers, according to the research company KLAS. “The replacement rate spiked over last year from 30 percent to 50 percent, especially in larger practices,” says the report “Ambulatory EMR Perception 2012.” The study uses data from 318 physician practices. Forty-four percent of practices that are replacing EMR systems are doing so because of product problems. Another 15 percent cite service problems.... Old women who receive radiation treatment after a lumpectomy are less likely to have to undergo a mastectomy later, according to a study published in the journal Cancer. The study, which looks at women age 70+, found that 10 years after a lumpectomy those who had follow-up radiation treatment had a 3.2 percent risk of mastectomy. Those who did not had a 6.7 percent risk. That’s a 67 percent reduction in the risk for mastectomy for the radiation group, the journal reports.... Hearing loss screenings for adults 50 and older should be done judiciously, says the U.S. Preventive Services Task Force. A hearing test should be done only if the patient shows symptoms or complains to the doctor. “If you have a hearing problem, you should absolutely bring it up with your doctor,” Albert Siu, MD, the co-vice chairman of the task force, tells Reuters Health. Also, doctors should not hesitate to inquire.... Drug-releasing stents prevent more adverse cardiac events than bare metal stents do, according to a study in the August 22/29 issue of the Journal of the American Medical Association. The study looks at about 1,200 patients in Israel and Europe who had a STEMI (an ST-segment elevation myocardial infarction).At the 1-year point, researchers found that 4.3 percent of patients with the newer model stents suffered adverse events, compared to the 8.7 percent of patients who used the older style stents. The study concludes that “Compared with a bare-metal stent, the use of biolimus-eluting stents with a biodegradable polymer resulted in a lower rate of the composite of major adverse cardiac events at 1 year among patients with STEMI undergoing primary PCI.”
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.