January 2016 Issue Preview (features)

The following topics will be featured in the January 2016 issue of First Report Managed Care. 

Hello, Goodbye: The implications of UnitedHealth Group’s potentially brief participation in the exchanges

Is this problem with the Affordable Care Act specific to UnitedHealth Group, or a more fundamental structural issue with the exchange products overall? FRMC will offer an in-depth analysis of what led to UnitedHealth Group’s difficulties, the impact leaving may have on the exchange, and how the risk pool be improved.

Breast Cancer Screening Guidelines

The American Cancer Society recently published guidelines advising women to begin mammograms later and have them less frequently. The change comes as evidence mounts that mammography is not as useful in young women, and its imperfections lead to false positives, which in turn lead to unnecessary tests, biopsies…and spending. However, some believe the guidelines went too far. We’ll examine the issue, and its effect on managed care.

Embracing Change: Are ACOs Working?

The momentum to establish accountable care organizations continues to grow, as both government and commercial payers make a push for providers to begin baring risk for patient populations. While in many respects the movement is still in its infancy, experts say the initial years of ACOs have highlighted important lessons learned along the way and have helped identify key qualities necessary for ACO's to achieve success in the years ahead. But finding success and transforming health care won't necessarily be easy.

Medicare Negotiating Drug Prices

In our last issue, FRMC’s panel of experts began analyzing the Republican presidential candidates’ positions on health care spending. Next we examine how the candidates feel about Medicare negotiating drug prices, and address the potential positive and negative effects this controversial proposal can have.