The Stead Health Group, Inc. - Insurers Demand Preauthorizing Scans

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The Stead Health Group has expertise in Health Care Communication Transformations, Operations Improvement, Strategic Planning and Positioning, Financial Analysis and Turnaround, Program and Service Line Development, Facility Planning and Development. We apply strategy, customized to each client, resulting in tangible, bottom-line financial improvements.

Newsflash

Medicare Payment Advisory Commission (MedPAC) announced that there was a $800M decrease in Part B spending in 2005 as compared to 2004. They attribute this to a shift to an Average Sales Price payment system for physician-administered pharmaceuticals, coupled with declining prescription volumes. One concern raised in their report is that fewer patients have supplemental coverage, particularly in hospital cancer programs. MedPAC report, January 2007

Insurers Demand Preauthorizing Scans

Diagnostic-imaging scans are the fastest growing healthcare procedure. Now, Insureres are demanding that they review and agree prior to performance of the scan. Blue Cross and Blue Shield of North Carolina, the state's largest health insurer, will join a growing list of companies that are requiring preauthorization for diagnostic-imaging scans. UnitedHealthcare of North Carolina also plans to introduce a preauthorization review of imaging. Physicians are concerned that these reviews may result in procedure delays and further inefficiencies in healthcare.

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