Are insurers ditching PPOs?

http://www.healthcaredive.com/news/are-insurers-ditching-ppos/423291/

Insurers that have been offering PPO plans in the healthcare marketplace appear to be cutting back on the number of offerings or eliminating PPOs from the marketplace altogether, leaving consumers with fewer options. Is this becoming an industry-wide trend?

“In the large group market, traditional PPO offerings have been on the decline for the last several years as Consumer Driven Health Plans have gained popularity,” says John Greenbaum, senior vice president and employee benefits practice leader at national insurance brokerage Risk Strategies Company. “In the group market, the move has largely been driven by market concern over the now-delayed Cadillac tax.”

According to Greenbaum, insurers offering products on the public exchanges have curtailed their PPO offerings in favor of high-deductible plans. “Their motivation has been the difficulty of achieving profitability in a regulated market with no ability to underwrite the quality of risk,” he says.

Teri Mullaney, President and CEO of DST Health Solutions, says there are benefits to both payers and consumers to moving away from PPOs:

Survey reveals 3 value-based payment trends to watch

http://managedhealthcareexecutive.modernmedicine.com/managed-healthcare-executive/news/survey-reveals-3-value-based-payment-trends-watch?cfcache=true

Population Health2

 

4 forces that will influence medical cost trends in 2017

http://www.healthcaredive.com/news/4-forces-that-will-influence-medical-cost-trends-in-2017/421162/

Binoculars

The healthcare industry is in a transformational period. The rising use of retail clinics, MACRA, population health efforts and the Medicare Part B demonstration are but a few examples of disruptive conversations being had in board rooms. Yet, all of these discussions are underscored by the one topic underlying most business conversations: the almighty dollar.

There’s a push and pull between healthcare services utilization and narrow networks focusing on value that could shift the medical cost growth rate in future years. “When medical growth outpaces general inflation, a flat trend is not good enough,” the report states.

“As a result, 2017 will be a tough balancing act for the health industry,” the report states, adding, “Healthcare organizations must simultaneously increase access to consumer friendly services while decreasing unit cost. Employers, worried that this current trend is at an inflection point that could turn back up, will demand more value from the health industry.”

CEOs and CFOs: 10 things demanding your attention this year

http://www.beckershospitalreview.com/finance/ceos-and-cfos-10-things-demanding-your-attention-this-year.html

Balance

8 developing healthcare trends

http://www.fiercehealthcare.com/story/8-developing-healthcare-trends/2016-02-07?utm_medium=nl&utm_source=internal&mkt_tok=3RkMMJWWfF9wsRonvqjKce%252FhmjTEU5z14ukkX6a2lMI%252F0ER3fOvrPUfGjI4ARMBjN6%252BTFAwTG5toziV8R7LMKM1ty9MQWxTk

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New report identifies one of the top trends is engaging value-conscious consumers