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Five Health Insurance
Predictions for 2009

Les Masterson, Senior Editor-Managed Care

Congress will cover more children and cut Medicare Advantage payments to private insurers this year, but 2009 will be a year of minor reforms, and plenty of debate and discussion rather than action. [Read More]
  January 7, 2009

 
Editor's Picks
High medical costs, low pricing hurts managed care
Managed care stocks took a nosedive in 2008 as the nation's largest health insurers saw their stock prices fall an average of 58%. Whether 2009 is a better year for health insurers is up for debate. While some experts expect Americans will delay doctors' visits and medical procedures, which will keep insurers' costs down, others believe large companies will cut jobs and, in turn, reduce health insurance membership. [Read More]
Massachusetts panel to examine payments to Partners
Massachusetts Governor Deval Patrick convened a panel of state officials to investigate an eight-year agreement between Partners HealthCare System Inc., and Blue Cross Blue Shield of Massachusetts. State officials are concerned that the handshake agreement between the state's largest provider and insurer inflated healthcare costs, which threatened the state's healthcare reform effort. Patrick said state officials are considering using state insurance regulations to block excessive healthcare premiums and the state's inspector general wants providers and insurers to delay signing new contracts until the administration creates new policies to limit premiums. [Read More]
Tufts Medical Center to break with Blue Cross
Tufts Medical Center warned that its doctors will no longer accept Blue Cross Blue Shield of Massachusetts' HMO coverage after Jan. 31 because the health insurer does not pay Tufts physicians at a reasonable rate. Tufts says Blue Cross pays its doctors and hospital 20 to 40% less than other major teaching hospitals and the medical center has reportedly lost $25 million treating Blue Cross members over the past five years. Blue Cross says the insurer has offered to pay Tufts a similar rate to other hospitals and physician groups and called Tufts' threat a negotiating tactic. [Read More]
CMS: MHS project costly, didn't reduce hospitalizations
The disease management-inspired Medicare Health Support project did not save money or improve patient behavior and self-management, according to CMS' second report on the program, which was released just before the new year. In its report to Congress, CMS' evaluator reviewed the first 18 months of the project and found unimpressive results. MHS ended last year because CMS was disappointed with the DM programs' results. [Read More]
Managed Care Headlines
Kaiser's Cleveland Clinic-only plan didn't work out for hospital, insurer
Cleveland Plain Dealer - January 6, 2009
Cigna cuts 1,100 jobs, expects charge of $40 million
Bloomberg.com - January 6, 2009
Stark reintroduces his healthcare bill
Wall Street Journal (blog) - January 7, 2009
Seven hospitals in New York accused of $50 million Medicaid fraud
New York Times - January 6, 2009
Fugitives flee South Florida with Medicare millions
Miami Herald - January 2, 2009
New York governor would insure dependents up to age 29
New York Times - January 7, 2009
Uninsured can get health plans as state's Cover Florida program opens
Orlando Sentinel - December 31, 2008
Nurse says IL hospital fired her because of husband's expensive treatment
Chicago Tribune - January 5, 2009
North Carolina offers health coverage to riskiest patients
Charlotte Observer - January 2, 2009

Events/Audio conferences
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
Listen Up
Individual Insurance Abounds
Fred Karutz, senior vice president of business development of Norvax, an online health insurance technology company, talks about the individual market and how the shift to individual policies is affecting healthcare. [Listen Now]
From HealthLeaders Magazine
Can Individual Insurance Work?

Individual insurance is seen as both a rescuer and a villain. Supporters view the individual market as a critical option for the otherwise uninsured, but foes say such products don't really protect consumers and can be inhumane to those who most badly need insurance. When it comes to the individual coverage market, remember these four truths. [Read More]
   
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Resources From HCPro

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