HCPro Health Plan Insider - June 9, 2010 | A Code of Conduct for Physicians View as a Webpage | Subscribe for Free
A Code of Conduct for Physicians
Elyas Bakhtiari, for HealthLeaders Media

When the American Medical Association recently released a 10-point "Code of Conduct" for health insurers, the public reaction from payers was pretty passive and politically correct. But privately, some people in the health insurance industry have been much less welcoming of the AMA's 10 commandments. Payers and physicians have a long history of bad blood, and the AMA's somewhat aggressive code didn't do much to improve relations. [Read More]
  June 9, 2010

 
Editor's Picks
Group health insurance rates on the rise
Group health insurance rates for small and midsize employers are surging for 2011 renewals, according to a survey by the Council of Insurance Agents & Brokers. Rather than absorbing the costs, most employers are changing their plan designs and passing on some of the increased costs to their employees, according to the CIAB's "June Employee Benefits Market Survey" released this week at the group's Employee Benefit Leadership Forum in Colorado Springs, CO. [Read More]
Failure to Extend COBRA Subsidies Could Hurt Many Families, Report Says
As of June 1, the COBRA subsidy initially granted under the economic stimulus legislation in 2009 is now expired, meaning unemployed workers will have to pay 100% of their COBRA costs. Without the subsidy, unemployed workers nationwide will have to spend, on average, 84.3% of their monthly unemployment insurance checks on COBRA premiums to maintain coverage. In other words, a lot of unemployed folks are going to lose their healthcare coverage. [Read More]
HHS warns Medicare insurers on rates
On June 7, insurers that sell Medicare Advantage plans must submit their 2011 bids to the government. In a letter to four insurance-industry executives, Health and Human Services Secretary Kathleen Sebelius warned the companies not to increase premiums and co-payments for seniors. "Focus on price and quality rather than asking seniors who need healthcare the most to pay more for it," Sebelius wrote in a letter. The letters went to WellPoint Inc., Cigna Corp., BlueCross BlueShield Association and Health Care Service Corp., according to a person familiar with the situation. Those executives met with Sebelius last month. [Read More]
Senate Amendment Includes Temporary Doc Fix, Plus Medicaid Extension
Under the Senate substitute amendment to the jobs bill (HR 4213) unveiled Tuesday, physicians would get some relief from the 21% cut in Medicare and TRICARE physician reimbursements now in effect. Using the same language found in the jobs bill passed by the House 10 days ago, physicians would see an increase in payment rates of 2.2% for the remainder of 2010 and a 1% increase in 2011. Rates would return to present law after 2011. [Read More]

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Managed Care Headlines
E-mails reveal rift over insurance caps in Massachusetts
Boston Globe, June 9, 2010
Executive pay casts Horizon Blue Cross Blue Shield in different light
Philadelphia Inquirer, June 7, 2010
NAIC Misses Initial Deadline On Medical Loss Ration Definition
Janice Simmons, for HealthLeaders Media, June 3, 2010
Report Second-Guesses Health Reform Laws but Finds Good Bang for the Buck
Cheryl Clark, for HealthLeaders Media, June 8, 2010

Webcasts/Audio conferences
June 23: Cardiovascular Service Lines Strategies
July 15: A Better Way Than Pay For Call Coverage
July 22: Marketing to Physicians: Increase Sales Success Through Measurement and Tracking

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Audio Feature
Preventing Missed Revenue Opportunities

Robert Sutton, partner at Chadds Ford, PA-based IMA Consulting, discusses tips for preventing missed revenue opportunities due to third-party payer contractual underpayment. [Sponsored by Emdeon] [Listen Now]
From HealthLeaders Magazine
Mayo's Medicare Move

Like many healthcare organizations, the Mayo Clinic loses money treating Medicare patients. But unlike many healthcare organizations, Mayo can afford to quit Medicare—at least at one small physician office in Arizona. So beginning in January, Mayo stopped accepting Medicare patients at one of its primary care clinics—Mayo Clinic Family Medicine-Arrowhead—current patients included. [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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