Dec 20, 2019 | Managed Care Friday
1. New #1: Primary care moves up 9 spots to become the top priority in our 2020 Managed Care Investment Index, results to be released in January. Telehealth, for all its critics, jumps 15 spots to #3 as part of a move to use it as a triple threat: interceptor of care, diverter and treatment. ‘We had been missing the point of tele for a lot of years. It’s a better way to do network steering,’ says Charles Bright, network relations for BCBS. Infusion, a staple in the top 20 recently, moves into the top 5, while PT, which had slipped, moves into the top 10. The changes are generally good...
Dec 13, 2019 | Managed Care Friday
600,000: Number of people who are weekly users of the drug methamphetamine in the United States. The State of South Dakota launched a media and billboard campaign -- ‘Meth: We’re on it’ -- to bring awareness to the epidemic and destigmatize substance abuse disorder. The campaign went viral on social media with many people questioning the ad’s message. The campaign uses a website to help educate people in the U.S. on the signs of meth addiction and provides the resources available to combat addiction. Volunteers Back: First Tennessee’s college football team, which heads to the Gator Bowl in 3...
Dec 6, 2019 | Managed Care Friday
10,000: The number of psychiatrists across the country we’re missing, and 40% of the ones we do have do not take commercial health insurance, according to a panel of Medicaid behavioral health professionals who debated the issues at BRG’s healthcare leadership conference Thursday in Washington DC. Other takeaways: payers are asking providers to ‘please accept Medicaid and please make telehealth work’, and they see a growing need for transitional housing for patients swept up in the opioid crisis. Worried Well: As Archie once said, ‘why do they always give me a shot where the pain ain’t…?’ It...
Nov 22, 2019 | Managed Care Friday
1. 5: The amount of copay for a Physical or Speech therapy visit starting in 2020 for Cigna HMO members in Arizona, a change from the $20 this year. 2. Concierge Is Back, With A Twist: A company called Accolade will act as the “front door” concierge practice for life science manufacturer EMD Millipore’s 18,000 some employees. BCBS of Massachusetts will administer the benefits but Accolade will be the contact - handling care management, triage, steering members to care, and managing costs. Think of it as a new version of a benefit manager. 3. 2021 National Network: If you’re a physician group...
Nov 15, 2019 | Managed Care Friday
We sat down recently with our managed care contracting veterans from more than 30 MA plans and provider groups, and they clued us in to several new and eye-opening changes finding their way into Medicare Advantage risk contracts these days, including increasingly shocking terms designed to protect the plan. In this special Managed Care Friday, we lay out some of the terms and lessons. Click to read more.
Nov 8, 2019 | Managed Care Friday
1. 174 of 221: Middle schools in our poll this week who said they hoped to add psych and mental health programming and staff into their 2020 offering, including experimentations with telepsych in some districts and partnerships with local mental health groups, but have ‘struggled to staff and recruit’ due to a shortage. Only 86 of the 174 say they filled their slots and started programming. 2. Extenders Win: In an effort to increase access to healthcare, Anthem Virginia now contracts directly with NPs and PAs for its Medicaid beneficiaries under new state regulations that took effect...
