| Consumer-directed healthcare bandwagon loses steam
|
Washington, D.C.—Despite earlier promises that consumer-directed healthcare (CDHC) programs would reduce healthcare spending by encouraging more efficient purchase of health services, consumer confusion and higher out-of-pocket costs seem to be slowing enthusiasm for these plans. |
|
| More on Desktop Resources (Dec. 2006): Will CDHC affect HMO enrollment?
|
| Price is paramount to survival in the current healthcare market. With skyrocketing premiums, moving toward an affordable level for both the employer and the employee/member is essential, experts agree. |
|
| Will CDHC affect HMO enrollment?
|
| The rise in popularity of consumer-driven healthcare (CDHC) will challenge HMOs to be at the top of their game, say industry watchers. |
|
| Consumer connection: Jack LeFort aligns CRM with CDHC to improve service and strengthen loyalty and retention
|
| Conventional wisdom says that to introduce real change, you need to bring in someone from outside. Jack LeFort, CEO and founder of Connextions Health, a company in the emerging field of consumer-directed healthcare (CDHC), has brought a similar paradigm shift to healthcare from the outside. |
|
| HHS, Congress encourage e-health development
|
| All health plans and providers that do business with Medicare, Medicaid and other federally sponsored health programs soon will have to adopt information technology standards and quality-measurement tools. The Medicare Modernization Act of 2003 (MMA) requires the Department of Health and Human Services (HHS) to establish standards for electronic prescription drug prescribing by 2008, and this policy is driving broader efforts to build health IT systems. |
|
| Real-time, point-of-service financial settlement: why health plans will lead the next revolution in healthcare
|
| As the nation faces a healthcare "affordability" crisis, market forces are driving changes such as consumer-directed healthcare, which is fueling the next revolution in healthcare: real-time transactions. At the center of this momentous change sits the health plan and its enterprise systems. |
|
| Can a $400 billion shift herald consumer wellness?
|
| The issues have been framed brilliantly, debated enthusiastically and examined closely. While it might not resemble the California Gold Rush, employers that implement wellness programs can still find significant rewards. |
|
| Medicare, insurers seek expansion of HSAs
|
| Supporters of consumer-directed healthcare options want Congress to increase tax breaks and coverage limits to broaden the appeal of health savings accounts (HSAs) linked to high-deductible health plans. Health insurers and employers back legislation that would expand tax credits and higher HSA contribution limits plus increase flexibility in the use of HSA funds. |
|
| Assess the price of paying for performance
|
| Pay for performance (P4P) is touted as the magic bullet du jour for our healthcare cost concerns. In mid-2005, CMS released its "Quality Roadmap" aimed at delivering "the right care for every person every time." Consistent with this initiative, CMS has published quality measurements and information directed toward the beneficiary, the provider and, ultimately, the purchaser audiences. |
|
 MORE ARTICLES
|
| Design communication with health literacy in mind
|
| A recent study by the University of Connecticut indicates that the cost of low health literacy to the U.S. economy is as high as $238 billion annually. It's imperative that health plans and systems drive new efforts. |
|
| Disease registries have flown under clinicians' radar screens
|
| Disease registries are gaining in popularity as electronic tools designed to give physicians clinical support to deliver appropriate care. |
|
| Sleepless nights cost billions in care and productivity
|
| The continual inability to fall asleep or stay asleep is keeping approximately one-third of the nation up at night. Individuals with insomnia incur $12 billion in direct medical costs and $2 billion in drug costs alone. |
|
| P4P programs aim to track, prevent growing MRSA epidemic
|
| Methicillin-resistant Staphylococcus aureus (MRSA), a type of bacterium that is resistant to certain antibiotics, has become a national epidemic, with increasing numbers of serious infections, hospitalizations and deaths. Hospital stays for these infections tripled from 2000 to 2005. |
|
| Innovative plan designs focus on consumer engagement, wellness
|
| The convergence of rising healthcare costs, increased cost sharing and demand by consumers for more participation in healthcare decisions is producing a variety of innovative health insurance solutions. |
|
| Shared decision making gains recognition as patient-centric care model
|
| The practice of shared decision making (SDM)—the collaboration between patients and caregivers to arrive at an informed, value-based healthcare decision when treatment options have features that patients value differently—is gaining recognition among health plans as a key function of a patient-centric model of care. |
|
| MCOs break the cycle in chronic care with interventions
|
| Although prevention has become a key element in traditional disease management programs—trying to prevent or mitigate a chronic disease before it exacerbates—that may not be sufficient when a patient has a late-stage or end-of-life condition. There is a new emphasis on caring for older adults with multiple comorbidities. Almost 80% of people 65 and older report having a chronic illness, according to the Robert Wood Johnson Foundation. |
|
| Updated Disease Management Guidelines Impact Investment Perspectives
|
| Disease management programs don't come cheap, but thanks to industry collaboration, purchasers are increasingly learning how to assess the business case for these programs. |
|
| DME coverage guided by medical, regulatory necessity
|
| As durable medical equipment (dme) becomes increasingly sophisticated, MCOs' challenges remain rooted in establishing medical necessity. To that end, most use strategies including prior authorization and coverage limits. Meanwhile, they must also satisfy changing state and national regulatory requirements. |
|
| MORE ARTICLES
|
