HCPro Health Plan Insider - June 3, 2009 | Private Insurers: Give Us the Medicaid Drug Rebate, Too View as a Webpage | Subscribe for Free
Private Insurers: Give Us the Medicaid Drug Rebate, Too
Les Masterson, Senior Editor-Managed Care

Private health insurance leaders are pushing Congress to allow insurers to benefit from the Medicaid Drug Rebate Program, which lets states pay less for drugs in their Medicaid program. There are two reasons behind the insurers' plea: a desire to improve the bottom line and a need to improve care coordination. [Read More]
  June 3, 2009

 
Editor's Picks
Three Issues Health Insurers Face as AHIP Kicks Off
Sure, the public insurance option is a topic on the minds of most health insurance executives, but there are other more immediate issues that insurers face, including declining membership and perceptions about insurance costs. One major health insurer is losing 0.5% of its membership every month and most people believe health plan overhead is driving healthcare costs. Many insurers are concerned about a public plan, but an immediate problem for them is how to retain members who are losing employer-based coverage. [Read More]
UnitedHealth Tells Medicare How to Look for More Savings
UnitedHealth Group said Medicare could save roughly $540 billion over the next decade if they followed many of the insurer's cost-saving programs and methods. The paper lists 15 suggestions for lowering the growth of health costs and comes just two weeks after an agreement among several health industry groups, including America's Health Insurance Plans, the American Medical Association, and the American Hospital Association, to find ways to reduce cost growth in the health sector by $2 trillion over 10 years. [Read More]
Targeted Tax Hikes Would Raise Billions for Health Reforms
Three studies released by the Centers for Budget and Policy Priorities say that billions of dollars could be generated to help pay for healthcare reform by raising taxes on alcohol and high-sugar soft drinks, and rolling back or eliminating healthcare flexible spending accounts. The CBPP studies did not have an estimate for the revenue that would be generated by the FSA rollback or elimination, but a penny-per-ounce tax on soft drinks laced with sugar or high-fructose corn syrup could raise $10 billion a year, while increasing the excise tax on alcohol could raise between $27 billion and $100 billion over 10 years, according to the studies. [Read More]
Insurers' role key to health system overhaul, CBO says
A government mandate that requires Americans to buy health insurance would not be considered a new form as taxation as long as people had the ability to choose between private plans and a public option, according to a Congressional Budget Office report. This is a vastly different view from the healthcare reform effort during the Clinton administration and should serve as a major talking point for the health insurance industry. [Read More]
Rescission policies a hot topic in California
The epicenter of the rescission debate has been California so it's no surprise that the state is looking to curb them. California Insurance Commissioner Steve Poizner plans to unveil proposed regulations today that would require insurers to write applications for coverage in clear language, allow applicants to check a "not sure" box about their preexisting conditions, and bar insurers from dropping a member if the companies did not thoroughly investigate an applicant's medical history before issuing a policy. Meanwhile, also in California, a judge ruled in mid-trial that Blue Shield of California had acted properly in canceling the health insurance policy of a member after he was seriously injured in a car accident. It's the first verdict stemming from the spate of rescissions that have enraged consumer activists and led to regulatory enforcement by the state. To complete the rescission trifecta in California, Health Net has agreed to pay California hospitals at least $1.95 million for care delivered to patients whom the insurer later dropped. [Read More]
Managed Care Headlines
Obama Wants Final Health Reform Bill by October
Janice Simmons, for HealthLeaders Media - June 3, 2009
UnitedHealth's Ingenix Buys Medical Bills Auditor
John Commins, for HealthLeaders Media - June 1, 2009
At least 52 million Americans Will Be Uninsured in 2010
Cheryl Clark, for HealthLeaders Media - May 29, 2009
Proposal Would Require Health Plans, Doctors to Cut Appointment Wait Times
Cheryl Clark, for HealthLeaders Media - May 22, 2009
Kennedy and Baucus 'seek common ground' on healthcare legislation
New York Times - June 1, 2009
Feds Target Radiology Imaging Payment Cuts
Cheryl Clark, for HealthLeaders Media - May 29, 2009
Mass Healthcare Reform's Success Comes From 'Shared Responsibility'
Les Masterson, for HealthLeaders Media - May 27, 2009
Aetna site hacked; 65,000 to receive credit monitoring
Hartford Courant/Associated Press - May 29, 2009
Massachusetts bill seeks health insurance option for firms
Boston Globe - June 1, 2009

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Health Forum
Making Consumer Incentives Work in a Care Management Program

Consumer incentives are often thrown around as healthcare panacea. Send out a few gift cards and watch program enrollment increase as members lose weight, quit smoking, and generally improve their health as bad habits are eliminated. However, the incentive isn't a silver bullet. [Read More]
From HealthLeaders Media
Recession Provides 'Teachable Moment' for Wellness

If we are going to alleviate some of the staggering healthcare costs associated with a large and aging workforce, we have to correct many of the poor lifestyle choices we've made over the last few decades. [Read More]
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Contact Paul Mattioli at pmattioli@healthleadersmedia.com.
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