HealthLeaders Media Health Plan Insider - November 17, 2010 | Health Insurers, Are you Prepared for a Rainy Day? View as a Webpage | Subscribe for Free
Health Insurers, Are you Prepared for a Rainy Day?
Jeff Elliott, HealthLeaders Media

It's good to be in the healthcare industry. And lately it's been particularly good to be a health insurer. Financial conditions have been favorable, but what goes up must come down and health plans are now bracing for the latter after a good summer run.[Read More]
cora nucci
  November 17, 2010

Editor's Picks
CMS Unveils ACA-Driven Innovation Center
Centers for Medicare & Medicaid Services Administrator Donald Berwick and Center Director Richard Gilfillan formally introduced the Accountable Care Act-directed program designed to research and test new means of providing and paying for healthcare. CMS says it is consulting various stakeholders, including hospitals, physicians, health plans, and consumers, as it tests different care delivery and payment models, such as the patient-centered medical home to find a more effective delivery system for Medicare and Medicaid beneficiaries. [Read More]
Major Changes to Healthcare Reform Law Unlikely
The 2010 midterm elections sparked speculation that a GOP-controlled U.S. House of Representatives would take great effort to derail, or at least attempt to modify, the healthcare reform package. According to healthcare industry leaders, the latter appears to be more plausible, but not assured. It may turn out that rather than repealing or modifying provisions of ACA, the greater struggle will be over money designated to fund certain programs outlined in Medicare payment revisions such as Accountable Care Organizations or the Center for Medicare Innovation. [Read More]
Medicare Advantage Demo to Use Financial Incentives to Boost Quality
The Centers for Medicare & Medicaid Services says it will update its five-star plan ratings in 2011, and use the new metric as the basis for quality bonus payments in a three-year demonstration project for Medicare Advantage health plans that starts in 2012. [Read More]
Intelligence Report: Hospital Mergers & Acquisitions
Brand-new research shows that 64% of healthcare leaders expect an increase in M&A activity between acute care hospitals and both diagnostic imaging and ambulatory surgery centers. As the transaction tide continues to rise, the newest HealthLeaders Media Intelligence Report, Hospital Mergers & Acquisitions: Opportunities and Challenges, reveals key insights to help keep you afloat. [Read More]
HealthLeaders Media Rounds: Building Accountable Care Organizations
Hospitals and physicians are working hurriedly to build systems of care that reward quality, outcomes, and high-value care—the ingredients of the accountable care organization. Innovative healthcare leaders like Carilion Clinic and Norton Healthcare are getting ready now for the future of healthcare system delivery. Join us on Dec. 9 from Carilion Clinic and share the lessons these leaders have learned. [Register today]
Breakthroughs Report: Future Healthcare and Collaboration
Explore strategies to accelerate the drive toward more cost-efficient and quality healthcare. In this new HealthLeaders Media Breakthroughs report, leading hospital systems—Virtua, Crouse Hospital, Heartland Health, and The Chester County Hospital—share insights and lessons learned. [Read More]

Managed Care Headlines
AHRQ: Rate of Adverse Events in Medicare Cases 'Disturbing'
HealthLeaders Media, November 17, 2010

The Road to PCMH
HealthLeaders Magazine, November Issue

Hospital Costs Up 8.2%, Healthcare Inflation Hits 6.3%
HealthLeaders Media, November 12, 2010

AMA Releases ACO Guidelines
HealthLeaders Media, November 12, 2010

Dearth of Primary Care Docs Threatens Provisions of Medical Home Model
HealthLeaders Media, November 12, 2010

Hospital Sues WV Over Medicaid Reimbursements
HealthLeaders Media, November 12, 2010

NH Hospitals Brace for Lower Payments for Medicaid Patients
HealthLeaders Media, November 17, 2010

Employers ready to raise the stakes for health incentives
The Los Angeles Times , November 15, 2010

Sponsored Headlines
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From HealthLeaders Magazine
The Physician's Place in the ACO

Development of accountable care organizations may be critical to holding down costs and improving quality. But how will doctors' roles change? [Read More]
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Audio Feature
Will DOJ Quash Insurers' Most Favored Nation Clauses?

A recent Department of Justice lawsuit threatens the "most favored nation" clauses common to many insurer contracts with healthcare providers. Attorney Dale Grimes of Bass, Berry & Sims discusses the potential upheaval associated with this contracting mainstay. [Sponsored by Emdeon] [