Jul 15, 2022 | Managed Care Friday
20: Percent of adults who have received a surprise bill for themselves or a family member this year, despite the No Surprises Act that went into effect at the beginning of the year. About 1 in 5 received a bill over $1,000, according to a Morning Consult survey. Those who received unexpected bills were most likely to get them for in-network lab work that was sent to an out-of-network lab. Unsurprisingly, 1 in 4 survey respondents indicated they have skipped or delayed healthcare services because they’re worried about these unexpected costs. Cataract Reversal: Aetna no longer requires prior...
Jul 8, 2022 | Managed Care Friday
$100: The per member per day fine health plans will now face if they do not post the negotiated rates they pay to in-network providers and potential out-of-network billable amounts patients may owe, due to a new regulation that went into effect last Friday. Though hospitals have been slow to post their prices since that transparency rule went into effect, the much larger potential fines health plans face seems to be having the desired effect. Many large plans, including United Healthcare, have already posted the required information. But even full health plan compliance won’t automatically...
Jul 1, 2022 | Managed Care Friday
$12-36: The amount Optum claims their new lab benefit management solution can save health plans on a per member per year basis. Optum is launching a new program to combat unnecessary clinical testing, which can account for up to 30% of all tests ordered. Optum will work with Avalon to administer the solution. As Good As It Gets? Jack Nicholson’s character Melvin Udall in the 1997 movie put OCD on the map, showing moviegoers just how debilitating obsessive-compulsive disorder can be when ordering breakfast, navigating sideways, and trying to court the waitress. 25 years since the movie...
Jun 24, 2022 | Managed Care Friday
29: Percent of 412 schools we polled in the spring who are looking to “hire” allergists, as part of trend of schools becoming more like quasi health centers. Several even report issues with students with allergies and co-occurring eating disorders. By comparison, 74% say they are trying to increase “mental health counselor” staff. Once upon a time if you had an allergic reaction you had to go sit in that wobbly chair next to the art cart in the hallway until mom or dad showed up. Nowadays, schools try to know about your allergy before it happens. High Deductible, Low Detection: A Harvard...
Jun 17, 2022 | Managed Care Friday
#1: The top bestseller in psychiatry this week is none other than the DSM-5 aka “the bible” of the psychiatry world. The latest version of the Diagnostic and Statistical Manual of Mental Disorders, released in March after nearly a decade without updates, has become a surprise hit likely due to increased demand for mental healthcare. The DSM is the top psychiatry bestseller on Amazon and the Wall Street Journal’s list, though physicians warn the book is intended for mental health professionals and not for self-diagnosing. But given the difficulties many still face in accessing mental...
Jun 10, 2022 | Managed Care Friday
13: Percent of employees at some of the US’s largest companies don’t believe their employer offers mental health benefits, when in fact they actually do, according to a recent survey commissioned by Human Resources Director America. Topping the list, 24% of Walmart employees claimed their employer doesn’t provide mental health resources, which is contradicted by 33% of Walmart employees who took the same survey saying they used employer-provided mental health services in the past year. Even more stark, the same survey reports that more than half of employees said they haven’t used any mental...
