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January 2, 2008
Preempting Reform
Brad Cain, Senior Editor-Managed Care

An ambitious plan to offer universal access to affordable healthcare services for every resident in San Francisco is now in jeopardy due to a ruling in a federal lawsuit. That lawsuit is challenging the legality of a fee the city plans to impose on employers who do not offer healthcare coverage to their workers. During its first six months of limited operation, the program enrolled over 6,500 residents and city officials planned to begin rolling out the program for all 73,000 uninsured residents beginning in 2008. [Read More]

 
Editor's Picks
U.S. ruling backs health benefit cut at 65
The Equal Employment Opportunity Commission said that employers could eliminate health benefits for retirees when they turn 65 and become eligible for Medicare. The new regulation allows employers to establish two classes of retirees, with more comprehensive benefits for those under 65 and more limited benefits for those older. More than 10 million retirees rely on employer-sponsored health plans as a primary source of coverage or as a supplement to Medicare. [Read More]
Healthcare expansions hit roadblocks
A year that began with great ambition for major expansions of health insurance in Sacramento and in other state capitals is ending with considerable uncertainty. The governors of California, Illinois and Pennsylvania proposed sweeping plans to restructure healthcare. But none has finished 2007 with bills passed and signed. In each state, the initiatives confronted entrenched opposition from insurance and other business lobbies that made it far more difficult to build a consensus for change than in the smaller New England states that acted in recent years. [Read More]
Insurers seek bigger reach in coverage
Acknowledging that too many people simply cannot obtain health insurance on their own, the insurance industry is proposing a series of steps the companies say would let more individuals obtain coverage. The proposals would make it harder for insurers to cancel policies or deny coverage to people with pre-existing medical conditions. [Read More]
California court curbs insurers' ability to rescind medical policies
California health insurers have a duty to check the accuracy of applications for coverage before issuing policies and should not wait until patients run up big medical bills, a state appeals court ruled recently. The court also said insurers could not cancel a medical policy unless they showed that the policyholder willfully misrepresented his health or that the company had investigated the application before it issued coverage. The unanimous decision by a panel of the 4th District Court of Appeal in Santa Ana is the latest blow to California insurance companies and the way they handle policy cancellations after patients get sick and amass major medical claims. [Read More]
Universal health coverage sought in Michigan
A campaign that claims support from Michigan labor and religious groups, the AARP and Lt. Gov. John Cherry plans to launch a petition drive to ask Michigan voters to approve statewide, universal healthcare. [Read More]
Insurer's $1 million grant to provide medical simulation center
The Anthem Blue Cross and Blue Shield Foundation plans to announce that it is making a $1 million grant to the Indiana University School of Medicine to help fund the completion of a new medical simulation center. [Read More]
Managed Care Headlines
NJ eyes others as it strives for a health plan
AP/Philadelphia Inquirer, January 2, 2008
Nashville-based Healthways signs deal with Colorado health plan
The Tennessean, January 2, 2008
New Jersey finalizes health plan to cover uninsured children
New York Times, January 2, 2008
Healthcare pushed to fore by California vote
Washington Post, January 2, 2008
Cigna stands by decision on transplant
Los Angeles Times, January 2, 2008
Tufts Health gives $500,000 to nonprofit
Boston Globe, January 2, 2008
Report offers plan for better healthcare, lower costs
Los Angeles Times, January 2, 2008
Medicare Advantage plan run by Kentucky doctors
Louisville Courier-Journal, January 2, 2008
Medicare chief on road again to plug prescription drug plans
Boston Globe, January 2, 2008
Study: Insured cancer patients do better
AP/Yahoo News, January 2, 2008
Upcoming Events
Developments in DM

Nursing program cuts readmissions: An advanced practice nursing program with a DM component has been shown to reduce the number of readmission hospital days for chronically critically ill patients. The idea behind the program is to allow an individual advanced practice nurse to communicate with caregivers, physicians, and facilities; follow a chronically critically ill patient through the healthcare system; and serve as an advocate for the patient and caregiver. [Read More]
Listen Up
Taking Advantage
UnitedHealth Group estimates that 46 percent of employees are not taking full advantage of their health benefits. In response, UnitedHealth has created United with Me, a program that analyzes whether employees are taking advantage of available resources and choosing the optimal health approach. In this podcast, Dr. Deneen Vojta, medical director for new product development at UHG, talks about how to drive behavior change, effectively reach consumers, and customize messages to improve the way people access and use the healthcare system. [Listen Here]
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