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May 28, 2008
Tackling Obesity via Benefit Design
Les Masterson, Senior Editor-Managed Care

Nearly 90% of people with type 2 diabetes are overweight, obesity is responsible for many cases of hypertension, and being overweight or obese is linked to increased risks for certain types of cancer. Despite those sobering facts, many still view obesity as a lack of will power and fail to focus on the health quandary that is leading to comorbidities, higher healthcare costs, and premature illness and death. [Read More]
 

 
Editor's Picks
Massachusetts Medical Society files suit over rankings
The Massachusetts Medical Society filed a lawsuit that alleges the Group Insurance Commission, Tufts Health Plan, and UniCare Life and Health Insurance Co., physician rankings for cost and quality measures have defamed physicians and forced patients to pay higher copays based on the rankings. Health plans have created Web pages with physician rankings as a way to provide greater transparency for patients. The lawsuit, however, alleges one physician was penalized for treating seriously ill multiple sclerosis patients and another who alleges he did not treat some of the patients listed in the health plan's medical claims. [Read More]
TX panel calls for state oversight of PPO health plans
A Texas commission has asked the state's Legislature to place all preferred provider organizations under state regulation for the first time. A report from the commission on the Texas Department of Insurance suggests that the state license all PPOs, which is the way HMOs are regulated. Four out of five insured Texans receive healthcare through PPOs. [Read More]
Nevada insurers targeting individual customers
With employers cutting health benefits, insurers are expanding efforts to sell coverage to the uninsured in Nevada—a state that is 21% uninsured. The health plans are offering individual high-deductible plans with health savings accounts and lower premiums in hopes of getting more of the uninsured covered. [Read More]
 
Managed Care Headlines
New CIGNA Web site lets plan members shop for healthcare
Atlanta Journal-Constitution, May 22, 2008
Anthem, OhioHealth join others in posting quality, price data
Business First of Columbus, May 22, 2008
Bush signs anti-discrimination bill
AP/Yahoo News, May 22, 2008
New Florida law allows low-cost health policies
New York Times, May 22, 2008
TennCare patient wins experimental treatment as rare disease worsens
The Tennessean, May 27, 2008
Connecticut healthcare effort takes a new turn
Hartford Courant, May 28, 2008
Utah lawmakers hope for customer-centric Web site
Salt Lake Tribune, May 28, 2008
Upcoming Events
On Demand: Legal and Tax Implications of Incentive Program Designs
On Demand: Value-based insurance design: Alternative to high-deductible plans
On Demand: Cultural Diversity and Disease Management
 
 
From HealthLeaders Media
Blue Foundation Launches $8 million Study on Child Obesity
The Blue Foundation for a Healthy Florida has launched an $8 million, four-year statewide initiative to determine what's causing nearly one-third of Florida's children to be either overweight or obese. [Read More]
 
Capitation Corner
Mine Your Data to Target High-Risk Members
Because they're at risk for the cost of care, capitated provider organizations often employ the same high-level analytics—health risk profiling, health data analysis, and predictive modeling—that are used by health plans. Despite these efforts, gaps in care persist. [Read More]
 
From HealthLeaders Magazine
Collect. . .or Else

HealthLeaders May 2008
A New York hospital's charge capture initiative gives the ED a financial boost. [Read More]
   
 
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