According 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/Medigap insurance is purchased by many Medicare beneficiaries to cover cost-sharing. A new paper confirms that having this insurance leads to higher Medicare spending.
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HealthSparq, a health care price transparency company which is owned by health plan company Cambia, has acquired ClarusHealth, which offers provider search capabilities.
http://www.healthsparq.com/about-healthsparq/press-releases/healthsparq-acquires-clarushealth-to-become-a-market-leader-in-quickly-growing-healthcare-transparency-industry/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.