Health Care Reform in the News

Top 6 Challenges for Managed Health Care in 2010

The top issue, within the managed health care system, is to define the role of government. This issue should be a top concern of the citizens of the United States whether you are insured or not.

This following list was recently released by the Managed Care Executive Group (MCEG) which is a leadership group of U.S. managed health care executives. The 2010 list is dominated by defining the role of government, affordability, and collaboration between agencies.

MCEG’s top 6 list is as follows:

1. Define the role of state and federal government with regard to health care: Government support, intervention, and regulation are having an increasing impact on the payer, cost, and marketplace strategies. According to MCEG, their intent is to focus on legislative and compliance demands from the government.
2. Healthcare reform: Overall reform legislation; regardless if it’s comprehensive or piecemeal, at the state or federal level, will result in several new agencies and grant programs. Also adjustments to the insurance market and payments will be affected. The group tends to monitor this affect.
3. ICD-10: MCEG feels the impact of changing to ICD-10 for medical record coding and billing is being underestimated and suggests the impact will be equivalent to the industry as Y2K. This impact will push many other Healthcare Information Technology programs to lower priority.
4. Data analytics and informatics: The investment in analytics will be driven by disease management, real-time decision support, case management, and customer segmentation. Clinical information will be broad that will enable caregivers to more precisely identify diagnoses and target treatment.
5. HIPAA (Health Insurance Portability and Accountability Act) 5010: New HIPAA requirements will present substantial changed in the content of the data submitted with claims as well as the data available in response to electronic inquires. The implementation of the HIPAA will require changes to the software and the systems.
6. Consumer response to healthcare changes: It is projected that a wave of consumers voicing their opinion on products, costs, networks, and reform will happen quickly as parts of the health care laws are rolled-out. Consumers will demand integration between Web-based technology and administrative services to improve their customer experience.

Old heath care is out; the new health care is coming in.

All citizens should watch closely as the new programs and reform is implemented. Most of these concerns listed above are with regard to information technology and the ease of obtaining real information. These are valid challenges for the health care reform laws as we live in a fast-paced information world. These new laws affect all citizens in one way or another.