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Can ACOs Crack the Healthcare Payment Code?
Cora Nucci, Senior Online Editor for HealthLeaders Media

The multi-year march toward an overhaul of the nation's healthcare delivery system begins this week.  The effects that healthcare reform will have on physicians, hospitals, and payers will be accompanied by disruption and discomfort, but may be mitigated by preparation.[Read More]
cora nucci
  September 22, 2010

 
Editor's Picks
Senators Question Insurers' Premium Hikes
Health insurers with the five largest enrollments nationwide—WellPoint, United, Aetna, Health Care Services Corp., and CIGNA—received a letter Monday from Senate Finance Committee Chairman Max Baucus (D-MT) and Senate Commerce Committee Chairman Jay Rockefeller (D-WV) asking them to explain their calculations behind "unnecessary" 2011 premium increases. The chairmen are critical of reports that blamed some of these premium increases to coverage changes made through the Affordable Care Act (ACA). [Read More]
Medicare Advantage Enrollment to Rise, Premium Costs Dip
Enrollment in Medicare Advantage plans, which provide services to about a quarter of the nation's Medicare beneficiaries, is predicted to go up by about 5% in 2011, while premiums on average will dip by 1% from this year, the Centers for Medicare & Medicaid Services (CMS) announced Tuesday. [Read More]
Premium Tax Credit Could Slash Private Health Insurance Costs
A health insurance premium tax credit that is part of the Patient Protection and Affordable Care Act could assist more than 28.6 million Americans in purchasing healthcare coverage—even if they have pre-existing conditions, change jobs, or experience drops in income, according to a study released last week by Families USA, a non-profit advocate for consumer health care. The credits will provide individuals and families with tax relief—based on both their annual income and family size. For example, the tax credits would be available for four-person families with annual incomes (in current dollars) of up to $88,200; a three-person family would be eligible with incomes up to $73,240. [Read More]
Use of Diabetes Oral Meds On the Rise
Between 1997 and 2007 the percentage diabetes patients using oral medication rose from 59.9% to 77.3%, while the percentage of those using insulin dropped from 38.2% to 24.4%, according to a brief by the federal Agency for Healthcare Research and Quality. The cost of treatment nearly doubled during that 10-year period, from $500 in 1997-1998 to $944 in 2006-2007. [Read More]
Intelligence Report: Physician Alignment in an Era of Change
Hospitals are looking to employ more physicians and buy more medical groups; at the same time, hospitals are receiving an increase in inquiries from physician groups for employment. But this marriage is not without trepidation. Elements of payment reform are expected to put considerable strain on hospital-physician relations. In this exclusive report based on original research and analysis, we find out what 258 healthcare executives and clinical leaders think about these topics and more. [Read More]
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Sponsored Headlines
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Managed Care Headlines
NAIC: Health Reform Provisions Unclear to Most Americans
John Commins, for HealthLeaders Media, September 22, 2010
Judge sets December 16 hearing on healthcare suit
Reuters, September 22, 2010
Health plan won't fuel big spending, report says
The New York Times, September 9, 2010
CBO: Obesity Pumps Up Healthcare Costs
Janice Simmons, for HealthLeaders Media, September 14, 2010
 
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From HealthLeaders Magazine
Strategies for Hospital C-suite Organization

We all know who holds the ultimate power in the C-suite, but what's the ideal balance of power among its other leaders? How do you get your top lieutenants working together as a team rather than as little tyrants lording over their healthcare fiefdoms? [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.
Discover how to integrate wellness into your DM programs.
Read about practical strategies for maximizing the effectiveness of health and disease management programs.
Learn how to educate and engage members.

Audio Feature
Payment Model Innovation: Sharing the Rewards of a Pay-For-Performance Program

Neal Peyser, Managing Director FTI Healthcare discusses the creation of payment incentives for better collaboration between hospitals and their medical staff. He describes how one facility was able to tap incentive payments from a commercial payer that were based on meeting quality and efficiency metrics, and share them with physicians. [Sponsored by FTI Healthcare] [Listen Now]
 
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