Apr 7, 2023 | Managed Care Friday
3.4%: The average amount ACA health plan premiums increased between 2022 and 2023, likely due to inflation and increased healthcare spending. The increase in premiums reversed several years of declines. Unsurprisingly, markets with a single insurer had premiums that were $128 more than in markets with considerable competition, at least 5 insurers. Worker’s Comp Alumni: Any guess on one of the most common reasons for worker’s comp claims among teachers? – that’s right, alumni basketball games. Hole In The White Bag: Regence BCBS will launch a new specialty medication network in January 2024...
Mar 31, 2023 | Managed Care Friday
25-35: The age group now charting their own path around what their “health plan” will be. For better or worse, younger populations are the likely target of a new wave of virtual-first health insurance plans that package telehealth services to ensure people have a medical home even if it’s not the traditional one. Some Anthem members in Georgia will now have access to their new Virtual-First health plans. Other insurers also offer these and use them almost as traffic cops for healthcare, steering patients to services as needed. These plans provide people access to an AI-driven symptom...
Mar 24, 2023 | Managed Care Friday
13: Percent of Cologuard tests that are reportedly positive, but the colonoscopy ends up negative, a "false positive," and so the anxiety of waiting isn't great for patients and now some payers are wondering exactly how many false positives there are, which might be a bigger issue. Where's The Surgery? Cigna has launched an education program for their Medicare members to push more procedures to non-hospital affiliated surgery centers, like shoulder arthroscopies and knee cartilage removal procedures at rates $1500 to $1800 less compared to health system owned facilities, a JAMA analysis...
Mar 17, 2023 | Managed Care Friday
10,000+: The number of mental health apps circulating on app stores, according to a recent estimate by the American Psychiatric Assocation. While some are filling an important gap in access to mental health treatment, not all apps are equal. An ORCHA review of more than 500 mental health apps found nearly 70% didn't pass basic quality standards, such as having an adequate privacy policy or being able to meet a user's needs. That figure is higher for apps geared toward suicide prevention and addiction, some of the most vulnerable populations. A number of apps are incorporating AI to help...
Mar 10, 2023 | Managed Care Friday
20: The percentage of colorectal cancers diagnosed in younger people, those 50 and below, in 2019, compared to just 11% in 1995, according to research published last week. Worryingly, providers don’t seem to know what’s driving the increase. While health plans have been trying to make it easier for their members to screen for colorectal cancer, such as mailing at-home Cologuard tests and dropping PAs and copays for colonoscopies, these are still typically limited to members who are at least 45-50+ years of age. Pre-Pay Review: Medical claims are increasing in complexity, according to a...
Mar 3, 2023 | Managed Care Friday
930: The number of family medicine and internal medicine residency positions that went unfilled in 2022 despite the significant need for more of these providers. The National Regional Match Program’s data shows that anesthesiology, radiology and surgery residencies tend to only have a few positions unfilled. Mouth Full: A dental technology company has launched a virtual platform for video visits with dentists and tools to connect patients with care. MouthWatch anticipates this platform will mostly be used for emergencies, prescriptions, second opinions, cosmetic consultations and preventive...
