HealthLeaders Media Health Plan Insider - March 30, 2011 | Physician Quality Ratings Imperfect, But a Start View as a Webpage | Subscribe for Free
Physician Quality Ratings Imperfect, But a Start
Margaret Dick Tocknell, Senior Editor

Payers have developed some sophisticated models to assess their high volume physicians in terms of quality patient care. Despite complaints and legal action, quality ratings are here to stay. Physicians are going to have to get used to it.[Read More]
  March 30, 2011

 
Editor's Picks
DOJ Widens Blue Cross Probe
The U.S. Justice Department is widening a probe of Blue Cross Blue Shield health insurance plans in several states, examining whether they are effectively raising health-insurance premiums by striking agreements with hospitals that stifle competition from rival insurers. Federal investigators, as well as some state attorneys general, have sent civil subpoenas to Blues health plans in the District of Columbia, Kansas, Missouri, North Carolina, Ohio, South Carolina and, West Virginia. [Read More]
Healthcare's $363 Billion in "Hidden Costs" Detailed
Unreported spending that falls outside of traditional healthcare costs—such as doctors and hospitals—makes consumer discretionary spending on healthcare the largest item in household budgets. Unreported spending includes unpaid supervisory care by relatives. [Read More]
Medicaid Skips Generic Drugs and Overspends by Millions
State Medicaid programs spent at least $329 million more in 2009 on 20 popular brand-name drugs than they would have if they'd used lower-cost generic equivalents, according to a study from the American Enterprise Institute. The study examined Medicaid spending in 45 states for 20 popular prescription drugs, including Risperdal, Wellbutrin and Zofran. [Read More]
Webcast: Boost Market Share with Your Oncology Services
Given the growing trend toward all-inclusive cancer centers, do you know how to differentiate your own oncology services to protect and grow your market share? Your oncology care is distinct. Its marketing should be, too. Join HealthLeaders Media on March 31 for this 90-minute Webcast, including Q&A and a case study, for valuable lessons from marketing leaders. [Read More]
Healthcare Leaders Reveal Uncertainties About Industry Direction
Dedication to mission is strong and getting stronger, but just how to accomplish that mission is less certain, according to the just-released results of the 2011 HealthLeaders Media Industry Survey. [Read More]

Health Plan Forum
10 Healthcare Reform Market Changes Affecting Physicians
While specific regulations from the Patient Protection and Affordable Care Act are still evolving, marketplace trends and healthcare reform have clear implications for physicians regarding private payer initiatives, physician-hospital integration, and government action. [Read More]


Managed Care Headlines
Budget battle poses threat to community centers
The Boston Globe, March 24, 2011

FL gov. announces board to study public hospital
The Miami Herald, March 24, 2011

Database tracks state healthcare reform initiatives
InformationWeek, March 25, 2011

Health law safety net gets little attention
Milwaukee Journal Sentinel, March 28, 2011

The ACO model: a three-year financial loss?
The New England Journal of Medicine, March 25, 2011

Medicare rise could mean no Social Security increase
St. Louis Post-Dispatch/Associated Press, March 28, 2011


Sponsored Headlines
Case Study: Mayo Clinic helps radiologists pinpoint potential problems : Mayo Clinic transforms the way it processes and interprets medical imaging results to enable more accurate detection. Powerful algorithms pinpoint potential problem areas within medical images and flag them based on the probability of abnormality. This process transformation increases diagnostic sensitivity for detection of brain aneurysms through intelligent flagging of high-risk areas.

Case Study: University College London Hospitals: UCLH had to adhere to the 18wkRTT requirements stated by the U.K. government. The BPM based Patient Tracking System (PTS) enabled them to better manage their clinical pathways and resources and also help improve patient experience by reducing uncertainty in the scheduling of treatments.

Discover, Interact, and Optimize for Smarter Healthcare with BPM Powered by Smart SOA: This IBM® RedguideTM describes one of the most significant challenges in healthcare today: the need for healthcare providers to effect patient care positively and proactively in the face of increasing patient load and information overload. IBM WebSphere® business process management (BPM) powered by smart service-oriented architecture (SOA), or BPM powered by Smart SOA, has the potential to maintain the medical common body of knowledge. It also makes critical, current data available to practitioners in a manner that is consistent with the evidence-based, event-driven environment to which healthcare aspires. BPM powered by Smart SOA can also automate healthcare provider administrative and care delivery processes.

Webcasts/Rounds

March 31: Boost Market Share with Your Oncology Services

On demand: Cardiac Care Leadership for Improved Alignment and Outcomes

SEE ALL WEBCASTS


 
 
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From HealthLeaders Magazine
Reform Sharpens Focus on Quality Outcomes

The ability to achieve and demonstrate quality outcomes is becoming increasingly important. [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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Read about practical strategies for maximizing the effectiveness of health and disease management programs.
Learn how to educate and engage members.

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] [Listen Now]
 
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