Second-quarter numbers for payers showed a steady engine that has withstood the strain of the past two years, most notably (the failed) Republican efforts to tear up the Affordable Care Act and other big moves from the Trump administration. Insurers appear to have found stability and responded by expanding offerings, pulling back on others, moving into new subsectors and partnering with or gobbling up other companies. Payer underwriting margins were strong overall with no apparent ramp up in underlying medical consumption, David Windley, managing director for healthcare equity research at Jefferies in Nashville, told Healthcare Dive. "2Q is a critical quarter for (managed care organizations) because it is the point at which management has seen enough actual data on claims payments to assess product pricing and any unusual trends," he said. Here are five trends and highlights from payers' earnings reports in the past few weeks. 1. Payers love Medicare … [Read more...] about 5 takeaways from payer Q2 earnings reports
Dive Brief: Small and medium business (SMB) payers make up a combined 83% of health plans, but they are often overlooked, according to a new Edifecs white paper on the topic. SMB plans showed little overall growth over the past five years, as the total number inched up from 402 to 409, but membership declined by 100,000 people. The SMB market has experienced "significant churn" with turnover in the market from mergers, acquisitions and closures, according to the paper. One trend in the SMB market is a move toward provider-sponsored health plans, which have increased by 13% since 2013. The move to provider-led or provider-owned plans comes as the industry creates more value-based care and payment reform models. More than 90% of provider-sponsored plans are in the SMB market despite being only 46% of all health plans. Dive Insight: The Affordable Care Act exchanges and larger employers drive much of the discussion about health insurance, but the new white paper … [Read more...] about Small, medium payers show growing interest in provider-sponsored plans
Single-payer health care is still a controversial idea in the U.S., but a majority of physicians are moving to support it, a new survey finds. Fifty-six percent of doctors registered either strong support or were somewhat supportive of a single-payer health system, according to the survey by Merritt Hawkins, a physician recruitment firm. In its 2008 survey, opinions ran the opposite way — 58 percent opposed single-payer. What’s changed? Red tape, doctors tell Merritt Hawkins. Phillip Miller, the firm’s vice president of communications, said that in the thousands of conversations its employees have with doctors each year, physicians often say they are tired of dealing with billing and paperwork, which takes time away from patients. “Physicians long for the relative clarity and simplicity of single-payer. In their minds, it would create less distractions, taking care of patients — not reimbursement,” Miller said. In a single-payer system, a public … [Read more...] about Doctors Warm To Single-Payer Health Care
TORONTO — For Dr. Peter Cram, an American internist who spent most of his career practicing in Iowa City, Iowa, moving here about four years ago was almost a no-brainer. Cram treats his move as a sort of life-size experiment. As a U.S.-trained physician and a health system researcher, he is now studying what he says is still a little-understood question: How do the United States and Canada — neighbors with vastly different health systems — compare in terms of actual results? Does one do a better job of keeping people healthy? For all of the political talk, in many ways it is still an open question. “The Canadian system is not perfect. Neither is the United States’,” Cram said over coffee in Toronto’s Kensington Market. “Anyone who gives you a sound bite and says this system should be adopted by this country … I think they’re being almost disingenuous.” Still, American support for government-run, single-payer health care, … [Read more...] about Looking North: Can A Single-Payer Health System Work In The U.S.?
When the American Medical Association — one of the nation’s most powerful health care groups — met in Chicago this June, its medical student caucus seized an opportunity for change. Though they had tried for years to advance a resolution calling on the organization to drop its decades-long opposition to single-payer health care, this was the first time it got a full hearing. The debate grew heated — older physicians warned their pay would decrease, calling younger advocates naïve to single-payer’s consequences. But this time, by the meeting’s end, the AMA’s older members had agreed to at least study the possibility of changing its stance. “We believe health care is a human right, maybe more so than past generations,” said Dr. Brad Zehr, a 29-year-old pathology resident at Ohio State University, who was part of the debate. “There’s a generational shift happening, where we see universal health care as a … [Read more...] about Once Its Greatest Foes, Doctors Are Embracing Single-Payer