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If Massachusetts is a Bellwether, Insurers May Soon Cut Payments
Elyas Bakhtiari, for HealthLeaders Media

Once again, Massachusetts is providing a testing ground for national healthcare policy. While the U.S. Congress is only beginning a debate about regulating and capping insurance premium increases, the Massachusetts government has already denied proposed rate hikes, and insurers' reactions in the state may foreshadow what's to come at the national level. [Read More]
  May 26, 2010

 
Editor's Picks
AMA Says Health Plans Should Enforce Rules in New 10-Point 'Code of Conduct'
The AMA released a 10-point "code of conduct" for health insurers, outlining behaviors the physician organization would like to see from health plans going forward. The list included patient-focused items, like avoiding rescissions or making premiums transparent, as well as physician-specific complaints about administrative hassles and physician profiling. The physician group plans to use the list to publish a scorecard of insurers in time for the launch of insurance exchanges. [Read More]
Study: Uninsured do not go to the ER more than insured
Consider this myth busted. A new study from the CDC found that those with health insurance are just as likely to use the emergency room as those without insurance. The results may surprise those of us who believed that ERs mainly serve uninsured people. However, the study did find that Medicaid patients used ER services at higher rates than both privately insured and uninsured populations. [Read More]
Study: Workers Will Continue to Rely on Employer-Sponsored Wellness
Although recently-passed healthcare reform legislation will open new options for many Americans to purchase insurance through exchanges, employer-provided insurance will likely remain the most common source of coverage, suggests a survey of more than 3,000 employees conducted by the National Business Group on Health and Hewitt Associates. That leaves employers with the burden of providing coverage and managing wellness activities for the foreseeable future. One of the most interesting findings from the study: Most employees are more motivated by "doing the right thing" than financial incentives when it comes to participating in wellness programs. [Read More]
HHS Asks Court to Drop Virginia Mandate Suit
The Obama administration on Monday asked a federal district court in Richmond, VA, to dismiss the state's lawsuit filed two months ago that said Congress had overreached its powers under the new healthcare reform law by requiring citizens in the 50 states to purchase healthcare insurance. This is one of several legal challenges to the healthcare reform legislation that will hit the courts in coming months. So far, the Obama administration is sticking with a consistent legal defense about the law's constitutionality. [Read More]
 
Managed Care Headlines
Government warns health insurance industry on mergers
Associated Press, May 25, 2010
Reform Law Could Extend Insurance to 13.7 Million Young Adults
Janice Simmons, for HealthLeaders Media, May 24, 2010
Insurers press for tightening of oversight
Wall Street Journal, May 21, 2010
Executive pay at Blue Cross in New Jersey getting scrutiny
AP/Philadelphia Inquirer, May 24, 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]
 
Health Plan Forum
Lessons Learned from Vermont on Building Community ACOs

Tucked into the new healthcare reform law are provisions to test accountable care organizations (ACOs)—groups of providers receiving set fees to deliver coordinated quality care to a select group of patients. But before most people even knew what ACO stood for, Vermont was ahead of the curve—putting together a strategy to launch three community-based ACOs by 2012. [Read Now]
 
From HealthLeaders Magazine
EHR and Market Growth

In a world of skyrocketing health costs and dwindling employer-based insurance members, the individual market is one of the few areas of growth opportunity for health insurers. And while the market is rife with politics and uncertainties, experts say insurers have an opportunity with individual markets to largely expand their programs. [Read More]
 
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Resources From HCPro

Learn how increased collaboration between providers and managed care payers has the potential to reduce costs, improve processes, and enhance patient care.
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