Washington will begin to reduce the number of people on its Basic Health Plan, a money-saving move critics say couldn't come at a worse time. The plan, subsidized by taxpayers, covers 105,000 low-income people. The state Health Care Authority plans to lower that number by 7,700 over seven months. The cuts are part of spending reductions ordered by Gov. Chris Gregoire to help balance the state budget.
A Sacramento, CA, judge affirmed the California Department of Managed Health Care's policy against balance billing, which is when out-of-network providers charge patients for services not paid by insurers. The California Medical Association and the California Hospital Association had tried to stop the balance billing ban, claiming the restriction was unfair and could undermine the networks and agreement in place between insurers and their member hospitals. The medical association said that it will likely appeal the case.
A showdown between CIGNA and Connecticut hospitals in Manchester and Rockville could end their relationship in a few weeks, sending thousands of patients scrambling for new doctors and forcing them to use other hospitals. CIGNA and the Eastern Connecticut Health Network, which includes the two hospitals, have failed so far to reach a new contract. The old one expires Dec. 31, and both sides expect to continue negotiations. The hospitals are fighting for higher reimbursement.
Nashville General Hospital, the city's financially troubled safety-net hospital, is being audited to see if it has addressed the issues identified in a 2005 audit, officials said. But Mayor Karl Dean's finance chief said Dean's administration had not requested the review of Nashville General Hospital at Meharry by the Office of Internal Audit, which is independent of the mayor's office and Metro Council. Any talk about the hospital's future being on the line is premature, Metro Finance Director Rich Riebeling said.
The push into retail medicine is regaining momentum, and Deerfield, IL-based Walgreen Co. projects having 400 clinics nationally by Aug. 31. Although the economic downturn slowed growth, retailers and hospital systems continue to open retail clinics. The number of U.S. clinics jumped to 1,135 by December 1 compared with 1,104 just a month earlier, according to Merchant Medicine.
Hospitals are finding it pays to pump up the perks as they compete for patients who want a bit extra, and have private health insurance. Because private health insurance offers better reimbursement than government payers like Medicaid or Medicare, the perks are partly meant to lure in more profitable patients, experts say. But others see a chasm deepening between hospitals pushing into leafy suburbs to grab market share and those serving poorer patient populations.