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February 6, 2008
Food for Thought
Brad Cain, Senior Editor-Managed Care

Considering the current health status of the nation, I doubt I'm alone when I say I could stand to lose a couple of pounds. Like many, I gained a little weight over the holidays and I'm sure all the chips and dip I consumed during the Giants' improbable Super Bowl victory did little to help the weight-loss cause. But even with an extra pound or two of winter insulation, my weight has never become a health issue. [Read More]

 
Editor's Picks
Massachusetts' subsidized insurance cost to double
The subsidized insurance program at the heart of Massachusetts' healthcare initiative is expected to roughly double in size and expense over the next three years. This unexpected level of growth could cost state taxpayers hundreds of millions of dollars or force the state to scale back its ambitions. The state has asked the federal government to shoulder roughly half of the program's cost from 2009 through 2011, but there is no guarantee of that funding. The Commonwealth Care program provides free or subsidized insurance for low- and moderate-income residents. [Read More]
Healthcare reform to shift focus
The demise of California's attempt at comprehensive healthcare reform this week means that advocates of overhauling the healthcare system will turn their focus back to Washington as an increasingly tough budget climate raises new questions about whether states can go it alone. [Read More]
Group offers doctors bonuses for better care
In an ambitious effort to shore up U.S. primary-care medicine, a coalition including GE, IBM and Verizon is launching an initiative to pay doctors hefty bonuses for creating "medical homes" for patients. The initiative is the latest and perhaps most far-reaching effort by Bridges to Excellence, a program backed by big employers and health plans to provide physicians with financial incentives for taking better care of patients. Last year, the program paid out roughly $10 million in bonuses to doctors in the 18 states where it is active. [Read More]
California HMO rules stuck in limbo
In order to ensure that HMO patients received timely appointments with doctors, a 2002 law instructed California regulators "to develop and adopt regulations to ensure that enrollees have access to needed healthcare services in a timely manner." The law required the new rules be enacted by January 2004, but The Department of Managed Health Care did not release its proposed rules until 2007. When HMOs and doctors groups objected to them, the department scrapped the rules in favor of ones that let health plans come up with their own methods of complying with the law. The plans have to submit their guidelines in October 2008. [Read More]
Managed Care Headlines
A new offer on insurance for kids
Washington Post, February 6, 2008
Docs oppose Aetna plan on colonoscopies
AP/Yahoo News, February 6, 2008
Fitch cuts UnitedHealth ratings
The Boston Globe, February 6, 2008
Georgia governor backs tax break on some health plans
The Atlanta Journal-Constitution, February 6, 2008
Healthways stock skids 16 percent on cloudy Medicare forecast
The Tennessean, January 30, 2008
Online house calls click with doctors
Los Angeles Times, February 6, 2008
PA-based insurer's CEO says Blues deal could hurt competition
Pittsburgh Post-Gazette, February 6, 2008
Missouri-based system to sever contract with UnitedHealthcare
Kansas City Star, January 31, 2008
Child coverage expands in Wisconsin
Milwaukee Journal-Sentinel, February 1, 2008
Ohio bill would extend health insurance coverage
Cleveland Plain Dealer, February 6, 2008
Ohio AG wants poor to pay same for care as insurance companies
Cleveland Plain Dealer, February 6, 2008
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Consumer Corner

Medical credit score now under development: As consumers become responsible for an increasingly substantial chunk of their healthcare costs, providers are faced with more patients who are essentially cash-only. That's adding to an already staggering bad-debt burden. [Read More]
Developments in DM
Physicians need DM in medical home model
There are signs that the advanced medical home concept is gaining steam: The increasing drumbeat emanating from physician groups, the reported success of Medicare's Physician Group Practice (PGP) demonstration projects, and two documents released in December 2007 that noted the benefits of having PCPs at the center of patient care. "People are realizing that if you are going to have any way of controlling the costs of healthcare and costs of premiums for people, we have to find effective ways to treat chronic illnesses," says David S. Herr, MD, chief medical officer at Rocky Mountain Health Plans in Grand Junction, CO. [Read More]
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Resources From HCPro

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