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June 11, 2008

If You're Going to San Francisco
Les Masterson, Senior Editor-Managed Care

Like many of the readers of this column, I am preparing for next week's America's Health Insurance Plan conference in the land of cable cars, fog, and Barry Bonds supporters—San Francisco. Before attending a conference, I take a step back and think about the industry and trends. There is no better place to come bearing questions than a national conference with hundreds of industry leaders. [Read More]
 

 
Editor's Picks
New York Medicaid to deny payment for hospital errors
First CMS, then health plans, and now New York. The Empire State's Medicaid program has announced it will stop paying for “never events” starting in October. New York is following CMS' lead in not reimbursing for errors, such as wrong-site surgery, wrong patient procedures, disability associated with treatment, and medication errors. The state's health department expects to save $6 million through the policy change. [Read More]
Highmark to give 'cyber' funds to doctors
Highmark Inc., has created a $29 million pool to help physicians upgrade their electronic record-keeping capabilities. The Pittsburgh-based health insurer had proposed a similar $26.5 million plan, called the Highmark eHealth Collaborative, in 2005, but that plan had stalled as the insurer waited for Internal Revenue Service permission. As a way to get around the IRS, Highmark has instead decided to reimburse the money itself rather than going through an intermediary. The fund will pay up to 75% of a physician's equipment costs, with a maximum of $7,000 per office. [Read More]
For managed-care industry, next two weeks could be telling
Financial analysts are predicting that the next week or two could be telling for managed care stocks as many insurers close their books on May results and make presentations at a major healthcare industry investor conference. Managed care stocks have declined year to date, though they have seen a rise over the past month. Despite the sobering numbers, some analysts suggest that managed care stocks have not entered a downward cycle. [Read More]
Minnesota-based insurer's venture to focus on wellness
HealthPartners is moving into the corporate health and wellness business. The Minnesota-based health plan will market wellness services to employers under the name of JourneyWell. The program offerings include phone counseling for stress and weight management and workplace fitness classes. Employers will pay between $60 and $150 per employee per year for a bundle of services. [Read More]
Massachusetts insurers expand use of doctor rankings
Despite the Massachusetts Medical Society's opposition to health plans' physician ranking systems, some insurers are looking to expand their offerings. One example is Tufts Health Plan, which plans to add more specialists to its tiering system, and expand from two to three tiers. Last month, the Massachusetts Medical Society filed a lawsuit alleging the rankings defame poorly ranked doctors who are offering high quality care. [Read More]
Aetna proposes insurance reform
A joint effort of the government and private sector is needed to resolve the number of uninsured Americans, according to Aetna Chief Executive Ronald A. Williams. Speaking in front of the Senate Committee on Finance, Williams said the healthcare system must face issues of cost, quality, and access of care to help the 47 million uninsured Americans. Three years ago, Aetna was the first national insurer to publicly endorse a health insurance requirement for Americans. [Read More]
 
Managed Care Headlines
Anxiety over health insurance shapes life choices
Wall Street Journal (subscription required), June 11, 2008
Clinton's exit deals setback to the push for healthcare mandates
Wall Street Journal (subscription required), June 9, 2008
Wal-Mart's detractors come in from the cold
New York Times, June 9, 2008
Ranks of underinsured are rising, study finds
New York Times, June 10, 2008
Senate Republicans tout alternative Pennsylvania healthcare plan
AP/Philadelphia Inquirer, June 11, 2008
New Jersey moves to tighten healthcare programs for poor
Philadelphia Inquirer, June 6, 2008
Web site will help the uninsured in North Carolina find resources
Raleigh News & Observer, June 6, 2008
Health insurers, businesses seek to limit costs in Massachusetts
Boston Globe, June 5, 2008
Study: Kentucky families need help with insurance programs
Louisville Courier-Journal, June 4, 2008
Audioconferences
July 22: Health Literacy: Four Ways to Create a Successful Program
On Demand: Legal and Tax Implications of Incentive Program Designs
On Demand: Value-based insurance design: Alternative to high-deductible plans
 
Listen Up
The High Cost of Obesity
HealthLeaders Media senior finance editor Philip Betbeze speaks with Joan Roberts, senior director at Novation, the contracting services arm of VHA, about the increasing costs to hospitals for treating the obese. [Listen Here]
 
From HealthLeaders Media
Online Ranking Sites Still Lacking
Government or payer reporting and ranking sites just aren't that user-friendly. Consumers want recommendations from people they know, not from some faceless government statistician and not from someone who may or may not be who they say they are. [Read More]
 
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