HCPro Health Plan Insider - September 16, 2009 | LifeMasters' Bankruptcy: Isolated Case or Part of Trend? View as a Webpage | Subscribe for Free
LifeMasters' Bankruptcy: Isolated Case or Part of Trend?
Les Masterson, Senior Editor-Managed Care

LifeMasters announced on Monday it has filed for Chapter 11 bankruptcy protection because it owes CMS $125 million for participating in three demonstration projects. But rather than question CMS and the Medicare Health Support demonstration project, Ariel Linden, DrPH, president of Linden Consulting Group in Hillsboro, OR, says the industry should instead learn from the failed MHS project and LifeMasters' experiences. [Read More]
  September 16, 2009

 
Editor's Picks
Many employers to raise cost of health benefits, survey finds
Forty percent of employers surveyed said they are likely to increase employee out-of-pocket costs in response to rising health costs next year. The Kaiser Family Foundation and the Health Research and Educational Trust found almost as many said they will likely raise deductibles and prescription drug costs. Eight percent said they plan to drop coverage entirely. All of these figures point to the need for health insurers to create ways to work with employers to bring down health costs and find ways to provide additional services to businesses and their employees to keep members healthier. [Read More]
Uninsured Population Hits 46.3 Million in 2008
The Census Bureau reported that the number of uninsured Americans increased to 46.3 million in 2008 with more than 1 million fewer Americans covered under employer-based health insurance. This is yet the latest report to show the erosion of the employer-based market. Health insurers are concerned about a possible public insurance option, but they should be even more worried about the loss of employer-based insurance and invest in individual health plans. [Read More]
Feds Lift WellPoint's Medicare Advantage, Part D Suspension
WellPoint, Inc., one of the largest health insurers in the country, can once again market Medicare Advantage and Medicare Part D plans on Oct. 1 and enroll new customers on Nov. 15. CMS had banned new enrollments for the large insurer because of complaints, but said WellPoint had made "sufficient progress in correcting its deficiencies." CMS also told WellPoint it will not automatically assign new low-income subsidy members, but those low-income members can choose WellPoint products during open enrollment. [Read More]
California Pushes to Enact Strongest Anti-Rescission Law in the Nation
California, often a leader in health policy, may soon have the toughest anti-rescission law in the nation. The legislation would set up an independent board, managed by two state agencies, which would have to approve any health plan's cancellation of an enrollee's plan. Only when insurers prove the applicant intentionally misrepresented his or her health on the questionnaire would cancellation be approved. If an insurer tried to cancel a policy without getting approval, the state Department of Managed Health Care and the Department of Insurance would impose administrative penalties. Not surprisingly, the California Association of Health Plans opposes the bill. CAHP's opposition is not because of the requirement for panel review, but because of the difficulty in proving someone intentionally withheld health information in an attempt to deceive. [Read More]
 
Managed Care Headlines
Nine Health Leaders Respond to Obama's Health Reform Speech
Les Masterson, for HealthLeaders Media, September 10, 2009
Some governors say Medicaid growth could hammer budgets
AP/Yahoo News, September 15, 2009
Public insurer support fading
Boston Globe, September 14, 2009
Government becoming insurer for more people
Wall Street Journal, September 11, 2009
New Health Insurer Rewards Patients Who Stay Healthy
Cheryl Clark, for HealthLeaders Media, September 15, 2009
AHIP Study: Medicare Advantage Provides Better Care Than FFS Medicare
John Commins, for HealthLeaders Media, September 16, 2009
Massachusetts insurers to boost rates about 10%
Boston Globe, September 16, 2009
Mandated health insurance squeezes those in the middle
Wall Street Journal, September 16, 2009

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Get Rid of the Paper Trail

Why should you go fully electronic when it comes to credentialing? For one, you could see as much as a 50% reduction in costs, says Matthew Haddad, president and CEO of Merversant, a company that offers Web-based credentialing to health plans. [Sponsored by Emdeon] [Listen Now]
 
From HealthLeaders Magazine
Are we at the Tipping Point for Health Costs?

As businesses balance rising health costs and declining profits on the backs of individuals, employee contributions to their healthcare are inching closer to 50% of healthcare costs. Have we reached a point at which the insured will drop coverage in great numbers because they simply can't afford it or find it's not worth the costs? [Read More]
 
From HealthLeaders Magazine
The Patient of the Future

Physicians suggest. Patients ignore. Technology alone won't bring them together. But a new relationship just might. [Read More]
 
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