Healthcare Finance Staff
Our weekly look at career moves in the healthcare finance sector. This issue highlights promotions, hires and fires for the week ending June 27, 2014.
Two large players in a small market are going to spend the next three years trying to collaborate with emerging incentives, as shared risk becomes the new normal.
The individual insurance market is now too big to ignore, drawing new crowds on and off state exchanges.
In this Golden Age of government programs, the health plan industry has never had more exposure to the generally poor performance of pharmacy benefit managers (PBMs). Performance metrics in Medicare, Medicaid and ObamaCare are directly tied to PBM execution, and the recent track record of these companies means they are the Achille's Heel of insurers.
As health plans start serving newly-insured populations and try to improve outcomes for long-time patients, all while taking on more financial risk, the case for aggressively targeting diabetes and obesity has never been greater.
The ambulatory surgery center movement has some evidence to back up arguments for its relative cost-effectiveness, although variation can still be vexing for health plans and patients.
The nation's diabetes and obesity crises have started taking their toll on healthcare spending, and some insurers are stepping in before new generations develop these problems in the long-term.
Just as government marketplaces are transforming their individual policy businesses, Blue Cross and Blue Shield companies are setting up private exchanges to save a far larger source of traditional revenue.
Many healthcare executives fall prey to two common misconceptions about data breaches: that the only companies making headlines for lax data security are big retailers like Target and that the biggest culprits are teenage hackers or sophisticated teams working in China or Eastern Europe.
Insurer premiums in the second year of public exchanges look financially wise to credit experts, although there are also some double-edged swords.