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Reform Update: Narrow Networks Bring Equal Parts Controversy and Savings
Health plans with narrow provider networks-which met with fierce backlash from patients and providers during the last go-around in the 1990s-are once again vulnerable to negative public opinion and legislative action.
Health plans with narrow provider networks—which met with fierce backlash from patients and providers during the last go-around in the 1990s—are once again vulnerable to negative public opinion and legislative action. But their failure now could undermine one of healthcare reform's key mechanisms for keeping premiums down, according to a special report from Moody's Investors Service.
The health insurance exchanges may suffer if plans and providers are required to broaden their networks in response to consumer backlash or new laws and regulations, Moody's Investors Service said in the report. “Narrow networks are one mechanism … that are being used by health care insurers to reduce healthcare costs,” said Moody's senior vice president Lisa Martin. Broader networks may include higher-cost hospitals such as academic medical centers which have added expenses for training future doctors. Premiums would rise to match the network's expenses, potentially driving away customers, Moody's said.
Marketplace success will depend on the degree that consumers trade off broad choice for cheaper prices and the strength of pushback from excluded providers.
Read the full story here: http://bit.ly/1nTjNfx
Source: Modern Healthcare
Dr Dalia Rotstein: Physicians Must Be Aware MS Affects People of All Backgrounds
April 24th 2024Dalia Rotstein, MD, MPH, emphazises the importance of awareness that multiple sclerosis (MS) impacts patients from various backgrounds as clinicians think through ways to improve access to care and research efforts in MS.
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Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
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Polatuzumab Vedotin and R-CHP Appropriate for Untreated DLBCL
April 24th 2024Population pharmacokinetic and exposure-response analyses revealed a favorable benefit-risk profilane for the treatment combination of polatuzumab vedotin and rituximab, cyclophosphamide, doxorubicin, and prednisone (R-CHP).
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Navigating Health Literacy, Social Determinants, and Discrimination in National Health Plans
February 13th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the February 2024 issue of The American Journal of Managed Care® about their findings on how health plans can screen for health literacy, social determinants of health, and perceived health care discrimination.
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Award-Winning Poster Presentations From AMCP 2024
April 23rd 2024At the Academy of Managed Care Pharmacy (AMCP) 2024 annual meeting, multiple poster presentations concerned with health equity, data collection, glucagon-like peptide-1 agonists, and more were acknowledged for their originality, relevance, clarity, bias, and quality.
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