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Two Reasons Health Reform Will Bring Medicaid Managed Care Expansion
Les Masterson, Senior Editor-Managed Care

Health insurance companies were largely winners in health reform as millions of new customers will soon flood their care pools. Sure, there will be those with pre-existing conditions and people who have gone years without preventive care because they have not had insurance. But reform will also mean many of the so-called "young invincibles" will buy insurance rather than face a fine. That's good news for health insurers. But there is a segment of health insurance that may get an even bigger boost—Medicaid managed care. [Read More]
  March 31, 2010

 
Editor's Picks
Health Reform Does Not Control Premiums, States Look to Fill Void
Health reform opens up coverage opportunities for the millions who are uninsured, most notably people with pre-existing conditions and those who previously could not afford coverage. However, health insurance critics are concerned that the federal health reform package does not have mechanisms to keep health insurance premiums under control. One state, California, is already working to put controls in place, such as requiring health plans to get prior approval before raising premiums over a certain threshold. [Read More]
Health premiums could rise 17% for young adults
An important piece of the health reform law is getting more young people insured. This is critical to health reform's success because bringing the so-called "young invincibles" into the care pool will help pay for the other newly-insured who have been denied coverage because of pre-existing conditions. Though many young adults will likely celebrate getting insurance, the other side of the issue is that their premiums will probably increase to help pay for the new, sicker members. [Read More]
Health insurers to comply with rules on children
Health insurers have agreed to comply with rules requiring them to cover children with pre-existing conditions this year. HHS Secretary Kathleen Sebelius spoke out earlier this week about concerns that insurers were going to use a loophole to not accept all children until 2014. In turn, insurers said this week that they will accept children regardless of pre-existing conditions later this year. [Read More]
Feds Provide $27 Million to Fund, Test Chronic Disease Programs
Health reform will likely provide a spark to the population health management industry and there was more good news for chronic disease programs this week. HHS Secretary Kathleen Sebelius announced $27 million worth of grants that will go to states to create and test chronic disease programs. The money comes from the stimulus package approved last year and federal officials hope the grants will help reduce Medicare's chronic disease care costs. CMS says that two-thirds of Medicare spending is for beneficiaries with five or more chronic conditions. [Read More]
Managed Care Headlines
Will Obama Name Don Berwick to Lead CMS?
Cheryl Clark, for HealthLeaders Media, March 29, 2010
Lobbyists Are Health Reform Winners
John Commins, for HealthLeaders Media, March 26, 2010
Eight Health Reform Provisions That Could Improve Women's Health Coverage
Janice Simmons, for HealthLeaders Media, March 29, 2010
Law may do little to help curb unnecessary care
New York Times, March 30, 2010
Keystone Mercy Health Plan restricts patients in dispute
Philadelphia Inquirer, March 29, 2010
Aetna creates new position: Chief nursing officer
Harford Courant, March 31, 2010

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