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February 20, 2008
An America Without Managed Care
Les Masterson, Senior Editor-Managed Care

After a second-place finish in the Iowa caucuses, John Edwards approached the microphone to present one of his classic "Two Americas" speeches. Knowing he was not only speaking to a couple hundred supporters in Iowa, but millions across the nation, Edwards dipped into his campaign quiver and pulled out his first arrow. He pulled back his bow and the arrow pierced the air and struck directly into the heart of managed care. [Read More]

Editor's Picks
Health plan rates may rise by 14 percent
Less than a week after Massachusetts officials announced that the state's unsubsidized Commonwealth Choice plans may face a 5 percent premium increase, state officials are considering raising premiums as much as 14 percent and doubling some copayments for the subsidized insurance program called Commonwealth Care. Officials say the increases are needed to protect the program from an influx of people whose employers may drop coverage, but advocates allege the hikes would price people out of the program. The increases would affect about half of the 170,000 low-income people enrolled in Commonwealth Care. [Read More]
Investigation may distract, cost UnitedHealth
It's been a rough week for UnitedHealth Group of Minnetonka, MN. First New York Attorney General Andrew Cuomo announced that he is investigating whether UnitedHealth subsidiary Ingenix manipulated data to lower its reimbursement obligation for doctors outside of its network. UnitedHealth's stock plummeted after the announcement. Those two news items followed UnitedHealth's settlement with 36 states for delaying or incorrectly denying health insurance payments last year. [Read More]
Legislation would crack down on insurers
A California bill would require health insurers to get permission from state regulators before retroactively canceling a member's coverage. The bill is in response to Blue Cross of California, which had been sending letters to doctors asking them to report pre-existing conditions and discrepancies that could be used to cancel a member's policy. After the practice made its way into the papers, Blue Cross initially defended the practice before announcing it would stop seeking the information from physicians. [Read More]
Insurer urges computerized prescriptions at hospitals
As a way to avoid prescription errors, Blue Cross and Blue Shield of Massachusetts is demanding that hospitals install a computerized medication ordering system within four years or face payment cuts. Blue Cross and Blue Shield announced the plan after a study found that one out of 10 patients admitted to six Massachusetts community hospitals suffered serious and avoidable medication mistakes. There are currently 10 hospitals in the state, mostly Boston's large academic hospitals, with computerized systems. [Read More]
Managed Care Headlines
Iowa governor announces his own healthcare proposal
Des Moines Globe Gazette, February 19, 2008
Laptop stolen with personal data on 300,000 health insurance clients
Information Week, February 19, 2008
CareFirst is investing $1.5 million in electronic records systems
Maryland Daily Record, February 19, 2008
CareFirst pledges to plug Medicare drug gap in Maryland
The Baltimore Sun, February 15, 2008
Insurers' ratings often aren't accurate, doctors complain
The Dallas Morning News, February 14, 2008
Finding a medical home may be just what the doctor ordered
Wall Street Journal (subscription required), February 14, 2008
Blue Cross halts letters amid furor
Los Angeles Times, February 13, 2008
Care, cost stressed in R.I. initiative
The Boston Globe, February 13, 2008
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Listen Up
MHS in Jeopardy, Part I
Vince Kuraitis, principal and founder of Better Health Technologies in Boise, ID, and Thomas Wilson, PhD, founder and president of Trajectory Healthcare and board chairman of the Population Health Impact Institute in Loveland, OH, discuss the Centers for Medicare & Medicaid Services' recent decision to end the Medicare Health Support project this year. This is part 1 of a two-part podcast. [Listen Here]
Developments in DM
BUPA buy gives Health Dialog room to grow
George Bennett, chair and CEO of Health Dialog, discusses how British United Provident Association's acquisition of the Boston-based company allows Health Dialog to improve care in the United States and worldwide. [Read More]
From HealthLeaders Magazine
Love Thy Vendor?

HealthLeaders February 2008 Providers and IT suppliers don't get along, right? You can build a partnership of trust with your vendor--and actually get what you pay for. Here's how. [Read More]
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Resources From HCPro

Prove the ROI on your disease management program.
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Learn about disease management and wellness offerings and uncover what your competitors are doing.
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