National Reports — The industry probably can look forward to further consolidation, as managed health insurers position themselves to better serve Medicare participants in the prescription drug benefit program scheduled to begin in January, and move to compete against other giant players in the industry, according to industry experts.
Obstetricians and surgeons are among those attracted to reform states.
Members of Congress began to roll out bi-partisan legislation.
Dr. Mark McClellan, administrator of the Centers for Medicare and Medicaid Services (CMS), plans to produce extensive information on how drugs and prescribing decisions affect health outcomes and costs by linking reimbursement data from Medicare prescription drug plans (PDPs) and Medicare Advantage (MA) plans with existing Medicare hospitalization and physician care databanks.
Several for ces are causing changes in healthcare payer IT investment priorities.
In the evolving process of electronically linking all aspects of the healthcare industry so that important data can be shared quickly, efficiently and effectively, another step is being taken, one that holds promise for those who take the time to understand the potential value as well as how to overcome some inherent challenges.
Practice takes back control of administrative functions
Realistic reimbursement calculations are crucial to any stragetic plan, but how do you arrive at a reasonable answer?
About three years ago I asked a large group of health plan executives if they knew how much they spend annually for ?specialty pharmacy? products. Few could respond, and virtually none had launched any efforts to control the then unknown rapid increase in these costs.
Today, this is not the case.
Computerized provider order entry reaches ambulatory care setting.