HCPro Health Plan Insider - February 24, 2010 | Michigan Blue Cross: Health Reform Villain or Health System Victim? View as a Webpage | Subscribe for Free
Michigan Blue Cross: Health Reform Villain or Health System Victim?
Joe Cantlupe, Senior Editor-Managed Care

Amid the controversy of insurance plans seeking large rate hikes, one company stands out, and that's Michigan Blue Cross Blue Shield. It stands out because it had the largest proposed increase for the individual market—56%—mentioned by HHS Secretary Kathleen Sebelius as an example of why health reform is needed. MBCBS is an interesting case study because nearly everyone agrees its fiscal situation has been a mess for years, and it's only going to get worse, unless the state acts, with or without healthcare reform from Washington, DC. [Read More]
  February 24, 2010

Editor's Picks
Four Ways Obama Would Fund Health Reform Plan
The healthcare reform proposal released by President Obama on Monday has some similarities—and some differences—to the Senate reform bill concerning how costs will be covered in the $950 billion bill. Obama's plan includes these four ways to fund the nearly $1 trillion plan: A Cadillac tax would impose a 40% tax on the value of higher cost health plans above a certain amount; a proposal to increase the Medicare Hospital Insurance tax base; more pharmaceutical money, calling for a $23 billion assessment in the Senate bill over 10 years; and a device manufacturing tax. [Read More]
CMS Announces Re-Alignment to Focus on 3 Key Areas
The Centers for Medicare and Medicaid Services announced it is realigning, consolidating, and integrating functions to "allow the agency to better focus on three key areas: beneficiary services, program integrity, and strategic planning," according to CMS acting Administrator and Chief Operating Officer Charlene M. Frizzera. "CMS is firmly committed to its mission of ensuring effective, up-to-date healthcare coverage and promoting high value, quality care for our beneficiaries. We are very fortunate to have dedicated employees who are passionate about CMS' mission and who work tirelessly to achieve it. Medicare, Medicaid, and the CHIP program now provide health insurance coverage to over 90 million Americans—a number that is expected to grow in the coming years," Frizzera wrote in an e-mail to agency staff. [Read More]
No Longer Waiting for Feds, States Jumpstart Health Reform
More than two dozen states have launched healthcare reform initiatives, but most are strapped financially and are unlikely to undertake major reform while federal legislation is stalled on Capitol Hill, says a top health official for the National Conference of State Legislatures. "A majority of states are clearly going to wait and see what the federal government is going to do," says Richard Cauchi, health program director for the NCSL. That doesn't mean the states have been inactive, Cauchi adds. At least 26 states are considering healthcare regulations ranging from management of chronic disease to healthcare quality improvements, as well as insurance programs for children, he says. [Read More]
Managed Care Headlines
A cautionary tale in healthcare reform
Los Angeles Times, February 22, 2010
States consider Medicaid cuts as use grows
New York Times, February 19, 2010
Patient-Friendly ER Lobby Designed to Reduce Stress
Ben Cole, for HealthLeaders Media, February 18, 2010
A cautionary tale in healthcare reform
Los Angeles Times, February 22, 2010
Scripps CEO Witnesses Devastation in Haiti While Gaining Valuable Disaster Training
John Commins, for HealthLeaders Media, February 17, 2010
Health insurers often balk at weight-loss surgery in Texas
Dallas Morning News, February 18, 2010
Ex-LA hospital owner convicted of Medicare fraud gets prison for recruiting Skid Row patients
AP/Los Angeles Times, February 23, 2010

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From HealthLeaders Media
Don't Let Your Wellness Program Obsess Over Weight Loss

If your employee wellness program offers smoking cessation classes, encourages moderate physical activity, and provides healthy food options in the cafeteria, you're on the right track. If the focus of your wellness program is weight loss, however, you're wasting time and money, and maybe even endangering your employees' health. So says Paul Campos, a professor of law at the University of Colorado, and the author of The Obesity Myth: Why America's Obsessions with Weight is Hazardous to Your Health. [Read Now]
From HealthLeaders Magazine
What Will Be the Payment Model in 2020?

Don't expect one payment model in 2020. There will be a hodgepodge of global payments, bundled payments, quality payments, and yes, even fee for service. But one commonality among all forms of payment will be greater collaboration between health insurance companies and physicians and hospitals. [Read More]
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