HCPro Health Plan Insider - December 16, 2009 | Four Presents Health Insurers Want Under Their Trees View as a Webpage | Subscribe for Free
Four Presents Health Insurers Want Under Their Trees
Les Masterson, Senior Editor-Managed Care

Health insurance leaders will place their stockings over the fireplace on Christmas Eve. They will put out milk and cookies for Santa Claus. All that will be left is the big morning when these executives head downstairs, gaze at the gifts Santa left, and rip open their presents. But what exactly does a health insurance leader want this year? Here are four gifts they would like to see under their Christmas trees. [Read More]
  December 16, 2009

 
Editor's Picks
20 People Who Make Healthcare Better
The very essence of healthcare is to make a difference for good, but the industry often doesn't recognize the many positives and the people performing life-saving work. Each year, HealthLeaders Media honors 20 people who make healthcare better. This year's list includes Cleve Killingsworth, president and CEO at Blue Cross Blue Shield of Massachusetts, which has been a leader in the quality contract movement; Atul Gawande, MD, whose New Yorker article became a key part of the healthcare debate this year; and A. Mark Fendrick, MD, of the University of Michigan, who is one of the creators of value-based insurance design. Check out how these three men and the 17 other professionals are improving healthcare. [Read More]
Blue Shield of California gets tough over late payments
Blue Shield of California is restricting late-payment grace periods to its individual insurance members. The insurer will continue to offer a 28-day grace period for those who miss payments. What is changing is Blue Shield will no longer have an additional twice-a-year 15-day grace period for its individual members. Members who don't pay promptly may lose health coverage. Those who are dropped can reapply for insurance, but could face higher premiums and stricter conditions. [Read More]
Independence Blue Cross plans more layoffs
Independence Blue Cross began its third wave of personnel cutbacks, with about 200 people expected to lose their jobs in the next several months. This will bring to 855 the number of job losses at the Philadelphia insurer since June. Joseph Frick, Independence Blue Cross' chief executive officer, explained in an annual report distributed to employees that the insurer does not expect to make its annual operating margin goal. Frick blamed many factors contributing to the "unfavorable performance, including higher-than-expected medical costs and a business environment that continues to have an adverse effect on our membership and revenue." Independence Blue Cross had a loss of $78.7 million in 2008, compared with net income of $170.9 million in 2007. Medical membership dropped to 3.3 million as of Sept. 30, compared with 3.4 million last December. [Read More]
Top 10 Smartphone App Trends for 2010
People with smartphones love looking for new apps. In this article, my colleague Cynthia Johnson writes about 10 trends for health leaders to expect in 2010, including augmented reality, EMR integration, and image viewing. [Read More]
CBO: Medical Malpractice Reform Could Save $54 Billion
The Congressional Budget Office (CBO) reported tort reform would lower healthcare costs both directly by reducing medical malpractice costs, and indirectly by reducing the use of healthcare services through changes in the practice patterns of providers. CBO estimates that enacting a package of proposals would reduce federal budget deficits by about $54 billion during the 2010-2019 period. [Read More]
Happy Holidays!
From all of us at HealthLeaders Media, happy holidays. Health Plan Insider will not publish next week, but will be back with a new issue December 30.
 
Managed Care Headlines
Public cooling to healthcare reform as debate drags on, poll finds
Washington Post, December 16, 2009
Move afoot to reward health consumer thrift
Wall Street Journal, December 15, 2009
Health insurance for California children in doubt
Los Angeles Times, December 15, 2009
Some Savings in Senate Reform Bill are Unrealistic, Says CMS Actuary
Janice Simmons, for HealthLeaders Media, December 11, 2009
Healthcare loophole would allow coverage limits
Associated Press/Boston Globe, December 11, 2009
Massachusetts health insurers mum on practices
Boston Globe, December 10, 2009
Web Site Hopes to Activate Diabetes Patients in New York
John Commins, for HealthLeaders Media, December 15, 2009

Webcasts/Audio conferences
January 22: Joint Replacement Service Lines: Alignment and Business Strategies for a Changing Environment
On Demand: Service Lines Strategies Workshop 2009: Stroke Care
On Demand: Finding and Keeping Physicians During a Shortage
Sponsored Headlines
Harnessing effective asset management in an uncertain economy from IBM  
Building a successful validation process and compliance support with IBM Maximo solutions  
Managing healthcare assets and optimizing asset utilization with IBM asset management tools  
Learn how Sisters of Mercy Health achieved its asset management goals in partnership with IBM
Listen Up
Reform's Effect on Health Insurance

Alan Katz, principal at the Alan Katz Group, past president of the National Health Underwriters, and blogger who writes about healthcare reform, talks about how reform could impact the health insurance industry. [Sponsored by Emdeon] [Listen Now]
Listen Up
HealthLeaders 20: Cleve Killingsworth

An interview with Cleve Killingsworth, president and CEO of Blue Cross Blue Shield of Massachusetts, who was one of our 2009 HealthLeaders 20. Find out how his company is working with physicians to bring better quality to the healthcare system. [Listen Now]
Listen Up
HealthLeaders 20: A. Mark Fendrick

An interview with A. Mark Fendrick, of the University of Michigan, who is one of the creators of value-based insurance design. Fendrick was one of our 2009 HealthLeaders 20. Find out about how VBID could affect healthcare. [Listen Now]
 
From HealthLeaders Magazine
Debate Pits Families Against Insurers

Many health insurers have historically covered medical and mental health-related services, but autism advocates and states are pushing for insurers to also pay for behavioral treatment, such as applied behavioral analysis (ABA), which teaches children social, motor, and verbal behaviors and reasoning skills. Activists say that autism is one of the top 10 most common neurological disorders, but is the only one that some health insurers don't cover. For health insurers, there is the question as to whether therapies like ABA should be considered within the scope of health insurance. The key phrase for insurers like WellPoint is whether the services are "medically necessary." [Read More]
 
Sponsor Health Plan Insider

Contact Paul Mattioli, Sr. Director of Sales, at pmattioli@healthleadersmedia.com or call 800.639.7477.
 
Resources From HCPro

Sign up to receive our new, free e-mail publication that offers concise updates on the top nursing leadership headlines, as well as best practices, practical advice, and expert strategies from nurse industry thought leaders.
Learn how increased collaboration between providers and managed care payers has the potential to reduce costs, improve processes, and enhance patient care.
Discover how to