Drug-Related Risks and Outcomes: 1st Annual National Report

The purpose of this first annual surveillance report is to summarize the latest information available on the national level for various drug-related risks and health outcomes, health behaviors, and prescribing patterns related to the drug problem in the United States. The most recent year of information available is different for different outcomes. The emphasis is on national information, but some state information is also presented. This document is intended to serve as a resource for payers, providers, and pharma companies charged with addressing this ongoing national problem. It will be updated annually.

Telehealth Payer Laws: Impact and Issues

Payers interested in the market potential of under-served rural populations long for consistent options for offering affordable policies without provider network limitations. The language policymakers use in telehealth legislation may deter provider networks from offering remote services and tying the hands of payers looking to broad service options, according to a the Center for Connected Health Policy (CCHP). The CCHP, with funding from the Milbank Memorial Fund, release a report covering the current state of telehealth payer laws.

Social Determinants: Payer Cases Improving Member Health

Currently, payer strategies focus on finding healthy populations, segmenting the markets, and segmenting populations, with the target of avoiding costly procedures. Population management and all the big data trends became useful tools in those payer strategies. With the results from a study by the Robert Wood Johnson Foundation and a position paper by America's Health Insurance Plans (AHIP), social determinants quickly rose as the next measurable data used by payers.

Autism Care Costs: Healthcare’s Perfect Storm

Autism care costs balance in the middle of many competing issues and agendas leaving payers, providers, and consumers trying to sort out the facts from fictions. The size of the funding pie “…over the next 10 years [is] about a half a million youth with autism spectrum disorder (ASD) will enter adulthood. The majority of the costs in the U.S. health care systems for ASD are directed at the adult population: $175 to $196 billion for adults compared to $61 to $66 billion for children.” writes Monica Oss, CEO, Open Minds.

Health Plans Create Best Practices: New Opioid Crisis Report

Health plans create best practices and lead with concrete strategies for preventing opioid overuse. The Association for Community Affiliated Plans (ACAP) recently issued a report detailing the innovations and best practices of its member Health Plans in their efforts to combat opioid misuse and overuse. The opioid epidemic led to an estimated 33,000 deaths and more than 300,000 emergency room visits in 2015, and recognized as a subject of intense debate on Capitol Hill and in statehouses around the country.

2017-07-25T16:06:19+00:00 By |Uncategorized|

5 Medical Cost Pressures Shaping 2018

The era of volatile swings and double-digit growth in employer medical costs appears to be ending. With medical cost trend hovering in the single digits for several years, the industry has been waiting for the inflection point when spending will take off. But that spike appears unlikely to happen. The New Health Economy is settling into a “new normal,” typically characterized by more attenuated fluctuations and a single-digit trend.For four years, medical cost trend has hung between 6 and 7 percent, seeming to settle into a “new normal.” PwC’s Health Research Institute (HRI) anticipates a 6.5 percent growth rate for calendar year 2018, half a percentage point higher than in 2017.

Shoveling Money Down Growing Behavioral Health Gaps?

Calculating future expenses stresses all managers and directors. In the ever-changing world of healthcare, making the time to accurately budget costs can cause headaches, nausea, dizziness, and palpitations. (Please do not operation heavy machinery while thinking about budgets.) Estimating the financial impact of the growing behavioral health gaps may be the final straw. Today's blog gathers data points from recent studies, reports, and presentations from around the healthcare industry and offers a starting point for your various budget models. Make the time to verify your models are sporting the most current data. Challenge your assumptions, because margins are thin and getting thinner.

2017-06-13T19:54:09+00:00 By |Uncategorized|

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