Legendary strategist Michael Porter has fixed his sights on health care and his latest missive in the Harvard Business Review lays out a vision which unfortunately is based on a…
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In a statistical brief that helps explain why so few younger Americans are signing up for coverage under the exchanges, AHRQ survey data for 2011 finds that 13.4% of adults aged 18 to 64 think they are two healthy to need insurance and 26% said health insurance isn't worth the cost, relatively stable with the same responses in 2010. But a smaller percent agreed with the statement in both years, indicating that attitudes can shift in both directions. Interestingly, wealthier and higher education people are more likely to say they need insurance and it is worth the cost.
http://meps.ahrq.gov/mepsweb/data_files/publications/st426/stat426.pdfMercom Capital Group released a report of VC funding for HIT in 2013, finding that $2.2 billion was raised, up substantially from $1.2 billion in 2012. There were 571 deals and 466 investors. There were two HIT IPOs in the year, and 165 M& A transactions in the sector.
http://store.mercom.mercomcapital.com/products-page/healthcare-it-reports/hit-2013-annual-and-q4-funding-report/A brief report from Mark Farrah Associates indicates that Blue Cross/Blue Shield plans currently enroll about 98.7 million Americans, 31% of the total population and 40% of the commercially insured group. There are 36 BCBS companies, several are large multi-state organizations such as WellPoint, with plans in 14 states and HCSC, with plans in 5 states, including Texas and Illinois. Blues plans received over $186 billion in premiums in 2012 and are the largest plans in 45 states.
http://www.markfarrah.com/healthcare-business-strategy/Blue-Cross-Blue-Shield-Plan-Consolidation-Continues.aspxAccording to Mark Farrah Associates as of December 1, 2013, there were 15,146,000 people in Medicare Advantage plans, about a 9% increase over the same time last year. UnitedHealth Group has about 21% of the market, followed by Humana with 16% and Kaiser with 8%. Around 17% of MA enrollment comes from employer retiree group plans. 2014 open enrollment ended on December 7, so the early indications are that there was strong growth.
http://www.markfarrah.com/healthcare-business-strategy/Medication therapy management has become more common, especially for the elderly. A review from the Agency for Healthcare Research and Quality finds little evidence to date that it improves most…
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HHS has announced that it will begin releasing physician level utilization data on a case-by-case basis. This is a huge development that will allow the identification of physician practice patterns and an understanding of which doctors may be engaging in inappropriate overuse.
http://www.modernhealthcare.com/article/20140114/NEWS/301149951?AllowView=VDl3UXk1TzRDL0NCbkJiYkY0M3hlMEtvaTBVZEQrYz0=&utm_source=link-20140114-NEWS-301149951&utm_medium=email&utm_campaign=hits&utm_name=topThe Employee Benefits Research Institute issued a short brief detailing reasons for wellness program participation. A survey found that the desire to improve health was the main reason for participating and that a belief that the person could make changes on their own or lack of time were the main reasons for not participating. Cash incentives and premium discounts would motivate more participation.
http://www.ebri.org/pdf/FF.263.Wellness.9Jan14.pdfUnited Recovery Systems, which provides receivables management across several industries, has acquired Financial Health Strategies, which provides revenue cycle management services to hospitals and health systems. United Recovery is backed by Audax Private Equity.
http://www.pehub.com/2014/01/pe-backed-united-recovery-systems-completes-fhs-acquisition/CareCore National, which began as an imaging benefits manager and has expanded to managing utilization and cost of other specialty care, has received a "significant" investment from Great Atlantic, a private equity firm, which probably means a majority recap transaction.
http://www.pehub.com/2014/01/carecore-national-partners-with-general-atlantic/About this Blog
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at khroche@healthy-skeptic.com.