Nov 3, 2023 | Managed Care Friday
Behavioral Health Expert Discussion: Register here for my live interview next week, Friday, November 10th, with Wendy Abraham, Utilization Analyst, APWU Health Plan, and Ish Bhalla, MD, Medical Director of Behavioral Health Value Transformation, Blue Cross NC as we discuss the complex behavioral health ecosystem. 67: Percent of physicians are concerned about the use of AI in healthcare decision-making, according to a Medscape survey. Most are more supportive of it as a tool to help with administrative tasks like scheduling and note-taking, but worried about it being used for more involved...
Oct 27, 2023 | Managed Care Friday
16.8: The percentage increase in hospital admissions in 2022 related to these diagnoses, representing the second biggest driver for a national union health plan with more than a quarter million members. We’ll give you a hint – it’s a famous Joe. That’s right, GI or gastrointestinal conditions are an increasing driver of hospitalizations, namely stomach, intestine, and pancreas related conditions – and drove more admits than lung, pulmonary, musculoskeletal and mental health. Save the date: Friday, November 10th, at noon ET for a ~30-minute live conversation with this union plan. 61: The...
Oct 20, 2023 | Managed Care Friday
145,000: The number of health care providers that left their jobs across 2021 through 2022 – almost half of them physicians, according to a data analysis by Definitive Healthcare. Worryingly, specialties that lost the most providers were internal medicine, family medicine, and clinical psychologists. Any Guess? The largest healthcare union is, wait for it, in Minnesota…where providers at Allina Health recently voted to unionize, which will create the largest healthcare union in the U.S. Union Deal: Healthcare unions have been in the spotlight recently – unions representing 85,000 Kaiser...
Oct 13, 2023 | Managed Care Friday
About 80: Types of virtual care losing insurance coverage in December under a new Aetna policy. Coverage ends for some behavioral care services, ophthalmological care, services related to end-stage renal disease and more, according to a notice sent to providers. The health plan will also end audio-only coverage of nearly 60 services, including psychotherapy, counseling for alcohol use disorder, and obesity counseling. We reached out for comment last week and expect a response shortly. Watch Out: Samsung is working with several health systems, including Mass General and Tulane School of...
Oct 6, 2023 | Managed Care Friday
1.8 Million: The number of people who received an updated COVID vaccine the week ending September 22. The number isn’t as high as many health professionals hoped, likely due to some glitches with the rollout and lessened demand. The cost for COVID vaccines has also switched from the government over to commercial insurance plans, possibly leading some to forgo the shot due to worry about potential copays, though health plans are not allowed to charge. Let The Drug Price Tactics Begin: Medicare Advantage insurer SCAN is getting ahead of the government's planned drug price negotiations by...
Sep 29, 2023 | Managed Care Friday
$226: Women’s average out-of-pocket spend is this much more per year compared to men’s even when excluding maternity services, according to a new Deloitte report. That adds up to $15.4 billion more in out-of-pocket costs across 16 million women with employer-sponsored health insurance. Women use health care more often, with 10% more in total health expenditures relative to men, but out of pocket spend is still 18% higher. This may be due, in part, to the different type of care recommended for women such as gynecological exams and earlier annual checkups. The VBA Effect: CommonSpirit, the...
