Feb 24, 2023 | Managed Care Friday
757: It’s a palindrome as my smarter nieces remind me. It’s also the average cost in dollars for about 1 out of every 10 patients a day who go to some of the urgent care centers in a New England suburb, but then need to be transferred to the hospital via ground ambulance due to things like low heart rate or difficult to diagnose headaches. If you’re pursuing urgent care, keep in mind these centers didn’t really exist before this century, that 1 in 5 patients you see are “more than likely worried well” and could wait 3 days for their symptoms to resolve themselves, but some patients will be...
Feb 17, 2023 | Managed Care Friday
58,200: The number of healthcare jobs added in January, with ambulatory healthcare services seeing the biggest increase. Despite this, health systems and independent providers are still struggling with staff shortages. Henry Ford said they’ve hired back only about 25% of their nurses who left during the pandemic and a recent article in NPR highlighted the increased use of mid-level providers in ERs. But It’s A Match: The number of internal medicine doctor residency training positions has fluctuated over the last three decades but offered 9,380 in 2022, the highest on record with 95% of them...
Feb 10, 2023 | Managed Care Friday
35 Million: The number of prior authorization requests submitted to Medicare Advantage plans in 2021, about 6% of which were fully or partially denied. But good news for those who take the time to submit appeals - ~82% of the appeals ended up being overturned. Anthem had the highest number of PA requests per MA member in 2021, followed closely by Humana and Centene. But submitting and appealing prior authorizations takes time and energy and is likely contributing to provider burnout. A study from Medscape showed that more than half of physicians report feeling burned out and nearly 25% feel...
Feb 3, 2023 | Managed Care Friday
40: The percent of parents who said they are “extremely or very worried” that their children are experiencing mental health issues like depression or anxiety, according to a new Pew Research Center study. Social media influences have been the #1 driver in research we've done, and the US Surgeon General recently stated that 13-year-olds are too young to join social media platforms. Solutions to help teens manage are increasingly centered around physical education in schools, whereas treatment for crisis continues to evolve. US Acute Care Solutions has partnered with Array Behavioral Care to...
Jan 27, 2023 | Managed Care Friday
38: The percentage of Americans who delayed healthcare treatment due to costs in 2022, a 12% increase compared to 2020 and 2021, according to a recent survey by Gallop. More than a quarter of those said the care they skipped was for “very” or “somewhat” serious conditions. Lower-income people, younger adults and women were more likely to delay care. In our own poll, nearly 75% of college age to 28-year-old males tend to skip care, not due to cost but due to fear. Fertile Ground: About one-third of infertility cases are caused by male reproductive issues, according to a study by the NIH....
Jan 20, 2023 | Managed Care Friday
28: Amount of market share on average that commercial payers say you probably need to have a fighting chance at leverage in reimbursement rate negotiations. The number varies by sub-sector and service and definitely geography. More recently payers are trying to hold the line on increasing rates, only allowing them if you are performing well, particularly around where you refer and how you treat. For instance, an OBGYN practice in the South has a high postpartum care and colorectal screening rate – 95% better than everyone else – and credentials all of its mid-levels with the payers, a...
