Health care reform demands greater need for rigorous, knowledgeable management of specialty health practitioners

By 2014, the number of Americans covered by health insurance will swell by an estimated 32 million Americans, a total roughly equal to the entire population of Canada. That is when the principal regulation under the federal Patient Protection and Affordable Care Act takes effect, extending medical coverage to most of the nation's uninsured. The mandate is designed to provide health benefits to more than 90% of Americans. One major challenge: The new law eliminates annual and lifetime dollar caps on benefits, which insurers have used for decades to help control costs. This lack of limits has special implications in one of the fastest-growing sectors of the health system -- specialty health care. The best specialty health care networks are run by experienced health benefits professionals who are fully accountable to their payer partners and their members. These specialty health network managers apply rigorous clinical and cost-management practices based on state-of-the-art, evidence-based research.