HCPro Health Plan Insider - December 10, 2008 | No Harry and Louise This Time View as a Webpage | Subscribe for Free
No Harry and Louise This Time
Les Masterson, Senior Editor-Managed Care

America's Health Insurance Plans has joined a growing list of stakeholders to propose healthcare reforms. The fact that AHIP is offering a plan shows stakeholders are working together this time around—not demonizing each other. [Read More]
  December 10, 2008

 
Editor's Picks
Michigan AG challenges Blue Cross' financial projections
Michigan's attorney general is asking Blue Cross Blue Shield of Michigan for more information about the insurer's projected losses on individual health policies. The request comes after the insurer requested the Legislature change the way the state regulates the nonprofit. As a way to help offset losses in the individual market, the proposal would allow Blue Cross to raise rates without getting approval from the state. The bill would also limit cherry-picking healthier people for individual health plans. [Read More]
Medicaid crisis hits Kentucky
Kentucky's Medicaid program is adding 3,000 members each month as residents lose employer-based health coverage because of the sputtering economy and lost jobs. This monthly infusion of new members is adding $11.4 million to the federal-state program each month. The state faces a projected $183 million Medicaid deficit for the current fiscal year, which is part of a projected $456 million revenue shortfall for the state. Kentucky is just one example of a state struggling with its Medicaid costs. [Read More]
Uncle Sam, secret Medicare shopper
Beware: The 70-year-old widow from Kenosha who is interested in learning more about Medicare Advantage programs might just be a government official. CMS and two contractors have been undertaking secret shopping missions following complaints about private insurers that offer Medicare Advantage. They found that some insurers didn't provide complete information about deductibles, restrictions, and copays. [Read More]
Commentary: Employer-based health insurance plans no longer work
Healthcare reform is on the horizon, but one idea that seems off the table is ending the country's employer-based insurance system. A Los Angeles Times columnist wonders why when consumers are not getting bang for their healthcare bucks. He questions whether the current system is the best way to provide coverage. [Read More]
Managed Care Headlines
Obama hopes to avoid Clinton healthcare missteps
AP/Yahoo News - December 8, 2008
Judge backs California in balance billing dispute
The Sacramento Bee - December 4, 2008
Connecticut activists prepare healthcare reform proposal
Hartford Courant - December 9, 2008
Aetna and BayCare hospitals far apart on contract
St. Petersburg Times - December 4, 2008
CIGNA dispute with Connecticut network could disrupt healthcare
Hartford Courant - December 4, 2008
7,700 to be cut from Washington's Basic Health Plan
AP/Seattle Post-Intelligencer - December 4, 2008

Events/Audio conferences
December 16: What Your Practice Is Worth: Calculating Fair Market Value
On Demand: Financial Meltdown: Managing Through The Crisis
On Demand: In-sourcing vs. Outsourcing Disease and Health Management: What's the Right Mix
On Demand: Health Literacy: Four Ways to Create a Successful Program
On Demand: Value-based insurance design: Alternative to high-deductible plans
Workplace Wellness
Employers favor carrot over stick
Two-thirds of surveyed employers are offering their employees incentive programs to improve health, but businesses are focusing on sparking participation rather than linking incentives to improved outcomes. [Read More]
Developments in DM
CMS unveils two-tier medical home care management fee
CMS' Medicare Medical Home Demonstration, scheduled to launch in 2010, will include a two-tier structure that is based on the practice's capabilities—with technology playing a large role in the more advanced tier. [Read More]
From HealthLeaders Magazine
The Big Keep Getting Bigger

Some major changes afoot for health insurance companies in the eastern United States have intensified concerns about the implications for the broader managed care landscape—and whether the next step is an industry ruled by a handful of insurance giants. [Read More]
   
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