CareValue’s Post

In addressing prior authorization concerns, five states' bills propose faster response times and public reporting. These initiatives, inspired by real-world experiences like Christopher Marks', seek to streamline patient access to vital medications. https://bit.ly/4bLAE2a HealthLeaders #payments #HealthPlans

"Facing regulatory and financial pressures, #BlueKC to exit #Medicare Advantage market by end of 2024. #HealthcareIndustry #InsuranceUpdate #healthcare #DistilINFO. https://lnkd.in/gC2WeRKZ

"Facing regulatory and financial pressures, #BlueKC to exit #Medicare Advantage market by end of 2024. #HealthcareIndustry #InsuranceUpdate #healthcare #DistilINFO. https://lnkd.in/gCcg8sgm

Canada's "free" health care costs $18,000 per year for a typical Canadian family. And for that, we get a failing healthcare system. Canada’s average healthcare wait times hit 27.7 weeks in 2023—the longest ever recorded. Among a group of 30 high-income countries that have universally accessible health care (i.e., it excludes the U.S.), Canada ranked: i. 28th (out of 30) for the number of doctors; ii. 23rd (out of 29) for the number of hospital beds available; iii. 23rd (out of 29) for the number of psychiatric beds available; iv. 25th (out of 29) for the number of MRI machines; v. 26th (out of 30) for CT scanners; and, vi. and had the longest waiting lists.   https://lnkd.in/g5Rt9EDm

This amazing story from the The New York Times is a masterful study in the perverse incentives of fee-for-service. Fixing our healthcare system requires a fundamental realignment that can only be accomplished with an accelerated transition to value-based care, much greater transparency, and continuous data-driven evaluation of incentives. https://lnkd.in/eCpfsia7 #healthcare #valuebasedcare

A new study from J.D. Power reveals that Medicare Advantage (MA) plans are significantly outperforming commercial health plans in terms of consumer satisfaction. MA plans earned an average score of 652 compared to 565 for commercial plans. Provider choice, lower out-of-pocket costs, and easier access to care are key factors contributing to MA's popularity. While national carriers generally score higher, some regional plans outperform even the best national options. Learn more: https://hubs.ly/Q02MpTKb0

Grift or defensive medicine; either way , we pay! One way to control health care costs: crack down on dubious diagnoses https://lnkd.in/dsTnk5nn #healthinsurance, #privatemedicalinsurance, #healthbenefits

Important paper on #Medicare registration late fees and how/why to avoid them. Also includes some thoughts for policy makers.

Check out this insightful article on the challenges many Americans face with medical bills: Nearly half of insured Americans encountered unexpected medical charges. If you or your employees are dealing with similar issues, PK can help. Contact me to find out more about how we can assist you! #Healthcare #MedicalBills #InsuranceAssistance

A few things to point out here: - Hospital prices rose 7.7%.... just in April - Rising hospital prices account for a 23% increase in US health spending per year Fully insured carriers subject to the MLR are operating on fixed margins. With that, the incentive for them to increase revenue is to increase spending e.g. pay higher claims costs via network contracts. In my everyday conversations, I frequently discuss the benefits (and necessity) of RBP. When done correctly, RBP is an effective way to mitigate claims costs, create transparency, alleviate pain points with Out of Network fees, and protect members from predatory billing practices. RBP takes some conversation and engagement; but with numbers like these, isn't that an easy trade off? #referencebasedpricing #employeebenefits #insurance #innovation #wallstjournal #RBP #levelfunding #network https://lnkd.in/es5tg8Tt