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Public Plan Won't Happen in '09,
But It's Inevitable

Les Masterson, Senior Editor-Managed Care

President Barack Obama and leading Democrats want a public plan, but even if it doesn't happen this year, the public option is a powerful negotiating tool. Health insurers and Republicans are so petrified of a public plan that they will likely give in on a number of other issues. [Read More]
  June 17, 2009

 
Editor's Picks
Senator Proposes Insurance Cooperatives as an Alternative to Public Plan Option
With growing momentum against a public insurance option, Senate Budget Committee Chairman Kent Conrad proposed an alternative—member-run healthcare insurance cooperatives. Conrad proposed the idea as a way to create more competition for private insurers while avoiding a government-run program like public insurance. Conrad highlighted Group Health Cooperative in Seattle as an example of a consumer governed, nonprofit healthcare system to emulate. [Read More]
Stakeholders' Reform Proposal Won't Save Much Money
The health reform plan offered by the American Medical Association, the American Hospital Association, and America's Health Insurance Plans might not save as much as hoped. The Congressional Budget Office added that most of the proposals are for steps that do not require federal government involvement. It may be back to the drawing board for the stakeholders. [Read More]
MedPAC Suggests Ending Medicare Advantage Overpayments
The Medicare Payment Advisory Commission (MedPAC) said the federal government will overpay private insurers by as much as $12 billion more for beneficiaries enrolled in Medicare Advantage plans this year than it would spend if they were in traditional fee-for-service Medicare plans. The higher payments to private insurers are supposed to fund additional programs such as care coordination, but MedPAC said some plans are offering no innovation and instead are mimicking fee-for-service Medicare. MedPAC proposed four solutions to resolve the issue, including setting benchmarks through competitive bidding. [Read More]
Obama is pressed to tax health benefits
President Barack Obama and leading Democrats are split on whether to tax employer health insurance as a way to fund part of healthcare reform. Obama opposed the idea during his successful campaign, and called the idea a tax on the middle class. Trying to find any way to help fund a more than $1 trillion health reform plan, some Democrats are pushing for a health insurance tax, while Obama is looking at taxing the nation's 3 million highest earners, which would allow the president to not break his campaign promise. However, some Democrats don't think taxing the wealthiest Americans could win Republican support. [Read More]
Health plans may fall short, Massachusetts officials say
Many Massachusetts health plans are finding ways around the commonwealth's health insurance requirement. State regulators said many health plans cap the benefits insurers pay each year on prescription drug coverage, exclude maternity coverage for dependents, or place an annual overall dollar limit on benefits. A state official said these results raise "difficult issues" and suggested the state review regulations to rectify any problems. [Read More]
 
Managed Care Headlines
Obama Pushes Public Plan with AMA
John Commins, for HealthLeaders Media - June 16, 2009
Employer Insurance Mandate Will Increase Jobs And Save Money
Cheryl Clark, for HealthLeaders Media - June 17, 2009
GOP Senators question Obama's health reforms
New York Times - June 15, 2009
Sebelius: Health plan would cut costs
Wall Street Journal - June 15, 2009
Health insurers refuse to limit rescission of coverage
Los Angeles Times - June 17, 2009
Massachusetts Senate to watch U.S. health plan
Boston Globe - June 16, 2009

Webcasts/Audio conferences
July 22: Service Line Strategies Workshop 2009: Spine Care
On Demand: HIPAA Changes: New Compliance Strategies for New Marketing Models
 
Listen Up
Dollars for Wellness

Wellness gets a lot of positive press, but there's often little in terms of carrots or sticks in many employer-sponsored programs to get measurable results. It's different at Carolinas Health System. [Read More]
 
Health Forum
Healthcare Reform Takes More than Technology & Government

It is not the clinical care that is the problem. It is the administrative processes that surround clinical care that creates the increases in rapidly growing healthcare costs, healthcare system inefficiencies, and opportunities for error in all aspects of patient care, as well as, practice, facility, and health insurance operations. [Read More]
 
From HealthLeaders Magazine
Employers Paying Now to Save Later

Value-based insurance design departs from the growing trend of passing along costs to consumers. [Read More]
 
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