Managed Care Friday

5: The number of chronic conditions that cost employers $2.5B over 2 years, according to a new study published by UnitedHealthcare’s Center for Advanced Analytics, using claims issued by the Health Action Council’s 57 employer members. Asthma, diabetes, hypertension, mental health/substance abuse, and back disorders were the top offenders and the study found that more than 60% of workers experience at least 1 of these conditions. This probably comes as no surprise to most employers, who are increasingly turning to new programs and strategies, including digital health options, to help manage...

Recent Developments in Podiatry

Recent developments in podiatry include E&M reform, positive FFS reimbursement changes, and increased demand due to aging population and rising prevalence of diabetes. Click to read more.

Medicaid Weekly Update

The brief highlights recent Medicaid policy developments in key states over the past week, including, but not limited to: CA:  State further delays Medi-Cal Rx transition due to Centene-Magellan deal IL:    Gov. Pritzker releases FY22 state budget proposal TX:  State to hold public hearing for proposed Medicaid rates for autism services Click to read more.

Eating Disorder Treatment Data Shows Major Access Drop-Off

In recognition of National Eating Disorder Awareness Week (February 22-28, 2021), BRG analyzed commercial eating disorder treatment utilization data across the US. Our research found that gaps in access to treatment remain an issue in many areas. The opportunity to expand access to ED treatment is substantial, especially as the health system continues to adapt to federal mental health parity regulations and awareness of the condition grows. Click to read more.

Managed Care Friday

3D: Beginning in April, Harvard Pilgrim Health Care will provide reimbursement for digital breast tomosynthesis (3D mammography) for commercial members in all states the plan covers. Harvard Pilgrim recently merged with Tufts Health Plan, although the two will keep their products separate for the time being. Lab Disruption: United is planning to launch a Designated Diagnostic Provider program in July 2021 and there is already pushback against the health insurer’s plan. The program is designed for commercial members and will only cover outpatient lab services when delivered by freestanding or...