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Insurers Must Push Employers to Reward Value
Les Masterson, Senior Editor-Managed Care

While some employers keep dumping more premiums and copays onto the backs of their employees, other leaders are finding new ways to avoid a future of $10,000 deductibles. Though the private sector often leads, there are still plenty of employers not willing to test out new programs. Instead, they often look for more arcane ways to save on healthcare, such as shifting more costs onto the individual. But that way of thinking is not sustainable. [Read More]
  April 7, 2010

Editor's Picks
Massachusetts health insurers sue to raise rates
Five nonprofit health insurers, including Blue Cross Blue Shield of Massachusetts, are asking for a preliminary injunction against the state's insurance commissioner's decision to reject 235 of 274 proposed health insurance premium hikes. The rate increases, which ranged from 8% to 32%, would affect the small group and individual markets. The Massachusetts insurers said that the state's rejection distracts from the real health cost catalysts, such as rising medical costs. [Read More]
Massachusetts insurers call halt, get state warning
After Massachusetts declined their proposed rate increases, a number of insurers responded by saying they will no longer offer new coverage to small businesses and individuals, which is a key part of the state's health reform plan. In turn, state officials demanded that insurers post updated rates online to the state's site and resume offering policies. Here's a clear example of officials looking to make examples of insurers, which is an easy victory in the current climate. In order for any health reforms to be a success though, all stakeholders—including insurers—need to be onboard. Massachusetts is yet again serving as the test case in this latest health reform battle. [Read More]
Stellaris Health, Empire BCBS Trade Barbs as Contract Expires
Stellaris Health and Empire Blue Cross Blue Shield are in the middle of a bitter contract fight. The contract expired on April 1, but the ill will did not subside as the two sides continue to bash one another. "Our nonprofit community hospitals can no longer subsidize the record profits of a health insurance conglomerate, and that is what Empire expects us to do," said Arthur A. Nizza, president/CEO of Stellaris Health. In response, the health insurer said, "The issue at the center of the negotiation is Stellaris' demand for higher-than-market reimbursement rate increases. Though Stellaris earns a substantial profit on Empire's business and operates profitably overall, they continue to demand annual double-digit rate increases during the proposed period of the new agreement." [Read More]
Highmark Opening More Health Insurance Stores
Highmark Inc., announced it is opening four more health insurance stores in Pennsylvania. The company, an independent Blue Cross Blue Shield plan, already has two other Highmark Direct stores, which have seen a total of more than 20,000 visitors in a little more than a year. Highmark sees these retail spaces as places to meet potential and current customers and discuss possible coverage opportunities. Health insurers are watching the Highmark case, which could serve as a model for other insurers, especially once health reform's coverage provisions take effect. [Read More]
Managed Care Headlines
J.D. Power and Associates: Health Plan Member Satisfaction Tumbles
Les Masterson, for HealthLeaders Media, April 1, 2010
Short-term customers boosting health costs in Massachusetts
Boston Globe, April 5, 2010
New healthcare law is full of unknowns
Los Angeles Times, April 5, 2010
WellPoint hikes CEO's pay package
Los Angeles Times, April 5, 2010
Insurance pool to offer reduced-rate coverage
New York Times, April 5, 2010
Health tax may wallop Massachusetts towns
Boston Globe, April 5, 2010
Capital BlueCross Eliminates 182 Jobs
John Commins, for HealthLeaders Media, April 1, 2010

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Audio Feature
The State of HSAs

Martin Trussell, senior vice president of business development at First Horizon Msaver, a leading provider of health savings accounts, talks about the state of HSAs and how health reform will affect them. [Sponsored by Emdeon] [Listen Now]
Audio Feature
Strategies for Reducing Drug Spending

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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
Avoiding the $10K Deductible

Health insurance deductibles increase every year as employers and health plans look to pass costs to members and create better healthcare consumers. The average health plan deductible is about $5,000, as employers and health plans have expanded the deductible concept to PPOs and HMOs. If we follow this path, deductibles could balloon to $10,000 within the decade. That's one path. Another is happening in Oregon. [Read More]
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