HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, announced its list of the ten most important managed health trends to watch in the coming year.
1. The year 2006 will mark the biggest change -- and biggest free-for-all -- to hit the Medicare program since its inception -- Between 11 and 20 organizations are offering Medicare Prescription Drug Plans (PDPs) in each Medicare-defined region. Nine organizations are offering PDP coverage nationwide. In addition to PDPs, seniors face a huge range of coverage choices, from Medicare Advantage PPOs and HMOs to private fee- for-service plans. The Centers for Medicare & Medicaid is heavily promoting regional PPOs as a way to extend access to rural areas, but local health plans are still drawing the most interest. 2. Health plan mergers and acquisitions will continue -- In 2005, the largest plans, UnitedHealth Group and WellPoint Inc., increased market share through purchases of other health plans. Expect to see further activity in 2006: CIGNA and Aetna have spare cash, and Coventry Corp. seems ready for another acquisition. 3. Consumer-directed plans generate more media coverage than healthcare coverage -- A lot of health plans and financial institutions like the new Health Savings Accounts (HSAs) and their associated high-deductible health plans. However, traditional first-dollar-coverage health plans have loosened their restrictions in recent years and remain the first choice among consumers. Despite a lot of discussion, this is unlikely to change in 2006. 4. The uninsured remain uninsured -- Employers and government tried a variety of innovative ways of getting healthcare coverage to the uninsured in 2005. Attempts included "three-share" style plans in which government, employers, and employees each kicked in a third of premium, and Maine's launch of its Dirigo Health, but both saw poor uptake. Small-scale attempts to deal with a large-scale problem are no more likely to succeed in 2006. 5. Medicaid moves back toward managed care -- Texas, Ohio, and Georgia all extended their managed care Medicaid programs in 2005, moving large numbers of beneficiaries out of fee-for-service. This won't sweep the country in 2006, but expect to see several companies, including Aetna, extending their management of Medicaid. 6. Health plans continue their progress on encouraging electronic medical records (EMRs), and 2006 could be a break-out year -- Health plans love EMRs, which make tracking and quality checking of healthcare easier and cheaper, and want providers to love them too. So the upgrading of systems will continue, with dramatic initiatives by Kaiser, Blue Cross and Blue Shield of Massachusetts, and others. 7. HMOs decline -- HMOs have been losing market share. A few bastion states, like Michigan and Massachusetts, will have high HMO participation, but, as employers move more and more to self-insurance, HMO market share nationally will continue its decline. 8. Disease management expands -- Health plans will rely on disease- management programs to attempt to control costs, and are beginning to see results. The newest programs are in managing complex chronic conditions such as hemophilia, scleroderma, and multiple sclerosis. Such conditions are relatively rare, but greater oversight of each expensive case can show good financial return. 9. Individual insurance plans with basic benefits increase market share -- As the cost of health insurance rises for employers of all sizes, insurance is becoming more of an individual game. Health plans are tapping into this market with basic-benefits plans for recent college graduates, early retirees, and people between jobs. 10. Pay-for-performance shows its hand -- Health plans have been pushing pay-for-performance measures on physicians for several years. 2006 will be a critical year for measuring return on investment now that some P4P programs have several years' worth of data to evaluate. Does P4P improve physician performance or pay already high-performing physicians more for work they would do anyway? Results in 2006 will help answer these questions.
The full Top Ten Health Trends for 2006 report is available on request from email@example.com.
HealthLeaders-InterStudy, a company of Decision Resources, Inc. (http://www.decisionresources.com/), is the authoritative source for managed care data and analysis. For more information, please visit http://www.healthleaders-interstudy.com/.
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For more information, contact: Alex Jablokow Decision Resources 781-296-2562 firstname.lastname@example.org
CONTACT: Alex Jablokow of Decision Resources, +1-781-296-2562,