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ACOs May Lead to Health Insurer Partnerships with Physicians, Hospitals
Joe Cantlupe, Senior Editor-Managed Care

President Obama and members of Congress last week met in a "summit" to discuss healthcare reform. Maybe he should have a follow-up with a specific healthcare focus: bring hospitals, payers, and providers—and no politicians—to the table, and talk innovative approaches to healthcare. During that discussion, Obama and healthcare stakeholders should consider Accountable Care Organizations, which some believe may jumpstart healthcare plans into a new cosmos of care, and would be truly emblematic of bringing everyone together as partners. [Read More]
  March 3, 2010

 
Editor's Picks
Senate Delays Doc Pay Cut for 30 Days
The Senate overwhelmingly voted Tuesday night to delay for 30 days a 21.2% pay cut in Medicare reimbursement for physicians. The tally came after Sen. Jim Bunning, R-KY, agreed to a vote after blocking the measure since last week. By agreeing to the physician pay cut delay, the Senate finally joined the House, which approved its 30-day delay legislation last week. By a 78-19 vote, the Senate approved the measure. Bunning repeatedly blocked the $10 billion measure since last Thursday, saying it was too costly, referring not only to the physician issue, but also to other programs, such as Medicare, COBRA, and unemployment and highway projects. While Bunning put a stranglehold on the measure, physician organization grew increasingly angry with the Senate, saying its inability to pass legislation was detrimental to patients, particularly senior citizens. [Read More]
Obama Incorporates GOP Ideas into Health Reform Plan
Less than a week after the congressional bipartisan healthcare summit, President Obama says he is willing to incorporate some Republican ideas in his health plan and wants Congress to pass healthcare reform legislation as early as late March, before the Easter recess. "After decades of trying, we're closer than we've ever been to making health insurance reform a reality," Obama said in a letter sent Tuesday to House and Senate leadership. He said the summit meeting left him "convinced that the Republican and Democratic approaches to healthcare have more in common than most people think." [Read More]
Lawmakers expand investigation into health plans' rate hikes
The scope of a congressional investigation into health insurance rate hikes in California expanded Tuesday as lawmakers summoned the chief executives of four of the nation's largest for-profit health insurers to testify about medical claims denied for individuals with preexisting conditions. The House Committee on Energy and Commerce and its investigations subcommittee are targeting the practices of WellPoint Inc., UnitedHealth Group, Humana Inc., and Aetna. [Read More]
Health Reform Proposals Will Make Matters Worse, Say State Regulators
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]
AMA leader disappointed that pay cut issue still unresolved
American Medical Association President-Elect Dr. Cecil Wilson talked this week with C-SPAN about the Medicare and Medicaid budgets, the proposed 21.2% Medicare physician payment cut, and his quotes that were in a recent HealthLeaders Media article. The House approved pushing back the payment cut scheduled for March 1 by one month, but the Senate has yet to take up the issue. Instead, CMS announced this week that it is asking contractors to hold claims for 10 days, which temporarily shelves the Medicare pay cut. CMS expects that provider cash flow will not be interrupted. [Read More]
Mission Driven, Financially Strong
Why is it that in times of economic stress, some hospitals manage through with strength to spare while others fall? While it may be tempting to say that those hospitals that thrive have the best payer mix or the most profitable service lines, often the deciding factor is the leadership's commitment to core principles of sound financial management. In this free HealthLeaders Media Breakthroughs report, four leading hospital systems—Banner Health, Southwest General Health Center, The University of Kansas Hospital, and Parkland Health & Hospital System—share the lessons they have learned to help them identify cost-cutting measures that also add value to care efficiency, make strategic investments in areas under your control, and refocus on the fundamentals of financial discipline. [Read More]
Managed Care Headlines
CMS Suspends Fox Insurance Drug Plan for Medicare Part D Issues
John Commins, for HealthLeaders Media, March 2, 2010
As costs rise, Florida lawmakers eye HMOs
Miami Herald, March 1, 2010
Battle over how to curb rising healthcare costs in Connecticut
Hartford Courant, March 1, 2010
Massachusetts unions safeguard health benefits
Boston Globe, March 1, 2010
Immigrants sue Massachusetts over exclusion from healthcare
Boston Globe, February 26, 2010
Plan offered to break impasse on healthcare in Minnesota
Minneapolis Star Tribune, March 3, 2010
WellPoint CEO takes on critics of rate hikes
Wall Street Journal, March 3, 2010

Webcasts/Audio conferences
March 8: Physician Compensation Models in a Strained Economy
March 30: Cancer Service Line Success: Better Coordination, Better Outcomes
March 31: Beyond ROI: Prove the Success of Your Marketing Efforts

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Audio Feature
Small Scale Reforms Needed in Health Insurance

John C. Goodman, president and CEO of the National Center for Policy Analysis, talks about how the government should initiate "small scale" health insurance reforms. [Sponsored by Emdeon] [Listen Now]
Audio Feature
Tips to Avoid Claims Denials

Judy Suska of IMA Consulting offers hospitals tips on working with health plans on claims denials. [Sponsored by Emdeon] [Listen Now]
Health Plan Forum
Voice Personality is a Powerful Lever to Motivate Health Behavior

In healthcare, individuals are educated and supported in the decisions they make about their health through communications. This article highlights a recent study of the impact of voice in healthcare communications and how individuals perceive voice as it relates to health messaging. [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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