Summarizing the Healthcare industry and the state of the precarious union between providers and payers is like trying to balance a gallon of fresh gelatin in your hands. Every time you think you've got it all together, it begins to slip to one side or right through your fingers. Healthcare is an industry perhaps more complex, fragmented and difficult to comprehend than any other. When we try to understand the dynamics that make our industry such a challenge in which to work, we inevitably underestimate the impact of one force or overlook a series of other competing agendas altogether. It's a slippery slope to think we can understand it all, let alone control it.
Welcome to MANAGED HEALTHCARE EXECUTIVE's State of the Industry Report. We hope to make sense of the various "balancing acts" in our industry and to prepare you for another challenging year.
Act 1: Capital Ideas. The State of the Industry Report monitors a market basket of metrics that in this particular year, demonstrate a leveling off of many economic indicators. Spending on healthcare services for privately insured individuals, for example, increased 8.2% in 2004, according to the Center for Studying Health System Change, virtually the same rate of increase measured the year before. However, this rate continues to outpace the growth of the economy overall, which increased a respectable 5.6% during the same period. According to the Center, continued or growing gaps between these measures will make health insurance increasingly more difficult to obtain and maintain for certain segments of the market.
If the health system CEO feels guarded optimism from the stabilization of industry benchmarks, the managed care CEO is likely basking in reports that this segment continues to be strong. Indeed, while half of the rated nonprofit health systems were downgraded versus upgraded, half of the nation's HMOs are considered "financially strong," according to Weiss Ratings Inc., an independent provider of ratings for service and financial sectors. Based on data from the second quarter of 2004, the percentage of insurers receiving a Weiss rating of A (excellent) or B (good) rose to 50%, a significant increase from 1998, when only 20.8% of HMOs qualified. Of the 482 HMOs reviewed by Weiss during 2004, 65 companies were upgraded, while only three were downgraded.
Bridging the Diversity Gap in Rare Disease Clinical Trials with Harsha Rajasimha of IndoUSrare
November 8th 2023Briana Contreras, an editor with Managed Healthcare Executive, spoke with Harsha Rajasimha, MD, founder and executive chairman of IndoUSrare, in this month's episode of Tuning in to the C-Suite podcast. The conversation was about how the disparity in diversity and ethnicity in rare disease clinical trials in the U.S. has led to gaps in understanding diseases and conditions, jeopardizing universal health, and increasing the economic burden of healthcare.
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Managing Editor of Managed Healthcare Executive, Peter Wehrwein, had a discussion with William Shrank, M.D., a venture partner with Andreessen Horowitz, a venture capital firm in Menlo Park, California, about how artificial intelligence's role is improving healthcare, where we are today with value-based care and the ongoing efforts of reducing waste in the healthcare space for this episode of the "What's on Your Mind" podcast series.
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FDA Site Inspections Decreased During Pandemic. Questions Continue about Drug Quality.
December 4th 2023A recent study has found that FDA inspections of drug manufacturing facilities have increased since the COVID-19 health emergency but have not yet returned to pre-pandemic numbers.
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