Kaiser Health News discusses a cost cutting approach finding increasing favor with insurers and self-insured employers -- "reference pricing." The article explains
Sarah Gardner wants her company’s employees to be savvy medical shoppers. So this year, she rolled out a plan that sets limits on how much the company will pay toward a range of tests and procedures, from MRIs to hysterectomies. Workers at Buffalo-based Prodigy Health now know to call their employee insurance plan to find a list of local doctors and facilities that meet the price. Or they can choose to go to a higher-price center elsewhere in the insurer’s network and pay the difference themselves.
Safeway employees in the San Francisco Bay Area, for example, face higher payments if they choose centers that cost more than $1,500 for a routine colonoscopy. And in January, the giant California Public Employees’ Retirement System (CalPERS) said it would not pay more than $30,000 toward knee or hip replacement. Workers who choose a hospital that costs more pay the difference. Next year, the program will be expanded to outpatient colon cancer tests, as well as some surgeries, including cataract repair for the 345,000 people enrolled in CalPERS’ preferred provider plans.In a piece of good news, the AMA News reports that
After years of doctors overprescribing antibiotics, physicians are beginning to heed experts' warnings to use the drugs more judiciously in the face of increasing antibiotic resistance, a study shows.
A Centers for Disease Control and Prevention study found that antibiotic prescribing rates for patients 14 and younger who visited a physician fell 24% from 1993-94 to 2007-08. During that period, the rate dropped from 300 antibiotic courses per 1,000 office visits to 229 courses per 1,000 visits, said the study in the Sept. 2 issue of the CDC's Morbidity and Mortality Weekly Report.Tomorrow is both the first day of Autumn and Falls Prevention Awareness Day.
According to the Centers for Disease Control and Prevention (CDC), one in every three adults age 65 and older fall every year. Among this age group, falls are the leading cause of injury death, with more than 18,000 older Americans dying each year from unintentional fall injuries. The CDC also notes that 20 to 30 percent of those who fall suffer moderate to severe injuries, including lacerations, hip fractures and head traumas. Such injuries diminish an older adult’s mobility and independence and can shorten overall life expectancy.Based on recommendations and guidance from the CDCl and the National Institute on Aging, UnitedHealthcare has recommended a dozen tips to create safer environments and otherwise reduce the risk of falls.: That's good guidance for FEHB plans to share with their enrollees.