Patient-centered medical homes increase patient satisfaction, according to a study in JAMA Internal Medicine (“Patient-Centered Medical Home Intervention Makes Some Progress”), but they actually seem to increase admission to hospitals. Emergency department use for PCMH patients was the same as for the control group.... Even if the electronic health record system that a physician practice installs does not meet the government’s meaningful use standards, it could still be effective, according to the Office of the National Coordinator for Health IT. Seventy-nine percent of physicians using EHRs that do not meet meaningful use standards say that their systems help their clinical efforts.... Private practice is dead? Not so, according to the American Medical Association. The majority of physicians own their own practices, says an AMA study that disputes all the talk of provider consolidation (http://tinyurl.com/AMA-practice-study). About 53% of surveyed physicians described themselves as self-employed in 2012.... Not only has the use of medications to treat attention-deficit/hyperactivity disorder in children soared the last five years, but now the stimulant drugs are being used to treat other neurological disorders, according to a study in the Journal of Child and Adolescent Psychopharmacology (http://tinyurl.com/meds-article).
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.