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Recon takes an analytical look behind select developments in healthcare
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- By Tory Wolff
Summary
Massachusetts small group went from an average actuarial value (share of expected medical costs covered by the benefit) of 85% in Q1-07 to 73% in Q4-09. In the same timeframe, actuarial benef…
- By Tory Wolff
Summary
Self-insurance is growing among smaller groups (including those sized 50-250)
From a competitive point of view, it will be hard for insurers holding attractive groups in risk products …
- By Tory Wolff
Public health insurers startled the market with earnings ~25% above consensus expectations. A key driver was lower-than-expected utilization (particularly in the under 65 commercial lives) which kept …
- By Tory Wolff
Summary
A new article in the NEJM suggests ACO economics will be unattractive because of the costly upfront investment and low probability of shared savings payments.
However, the results of the Med…
- By Tory Wolff
Summary
A new study from Center for Studying Health System Change suggests that new Medicaid eligibles under reform will have trouble getting access because most primary care are not accepting new M…
- By Tory Wolff
Summary
The line between health plan and provider continues to evolve: the Aetna-Carilion deal exemplifies providers backward integrating into insurance (and contrasts with other providers exit…
- By Tory Wolff
Summary
Health plan profits will be down dramatically in 2011 due to MLR rules
Providing care management services to providers building out ACOs and medical homes can open new revenue streams outsi…
- By Nikhil Bhojwani
Remember the idea that coordination will improve care? Well, if physicians do not get timely reports from other providers, their patients seem to have lower costs!!! This from a new study o…
- By Nikhil Bhojwani
New MedPAC report on Medicare fee for service utilization finds large geographic variation not explained by underlying risk or better outcomes. Another indicator of our HC system gone haywir…