HCPro Health Plan Insider - May 14, 2008 | Disease Management: In-source, Outsource, or Hybrid? View as a Webpage | Subscribe for Free
May 14, 2008
Disease Management: In-source, Outsource, or Hybrid?
Les Masterson, Senior Editor-Managed Care

Should anyone be surprised that health plans are exploring the most cost-effective ways to provide disease management? Questions abound about whether DM is cost-effective so it only makes sense that health plans would look to provide those services in-house. Whether the grass is actually greener on the other (in-sourcing) side though is still in question. [Read More]

Editor's Picks
More tying the knot to get health insurance
Do you take this insured individual to be your lawfully wedded wife? A Kaiser Family Foundation poll released this week found that 7% of Americans say they or someone in their household has married in the past year so they could obtain health insurance. The survey also found that healthcare costs outranked housing costs, rising food prices, and credit card bills as a concern. [Read More]
Ohio pharmacists want to expand role with patients
Pharmacists in Ohio want a greater role in patient care and hope to convince insurers that paying them for one-on-one time with chronic disease patients will improve outcomes and save money. Following the success of initiatives like the Asheville Project, in which pharmacists play a role on the care team, supporters have promoted the idea of medication management therapy as a way to help patients with chronic disease. In my April 2 column, I wrote about pharmacists taking a greater role in healthcare. [Read More]
Critics doubt Tennessee insurance bill will slash costs
A bill on the Tennessee governor's desk would allow small businesses to join together in cooperatives to buy health insurance. Supporters say the move would stabilize rates and help ease the health insurance burden of small employees. Critics, however, say the bill would not significantly lower costs or provide more coverage for uninsured employees. [Read More]
Iowa governor signs $25 million healthcare package
Iowa Gov. Chet Culver signed a legislation package this week aimed at extending health insurance to the more than 50,000 uninsured children in the state. Culver says the plan should allow the state to become the first to insure every child. The legislation also allows Iowans to remain on their parents' health insurance until they are 25 and bans insurance companies from using pre-existing conditions to stop consumers from switching from a group to individual policy. [Read More]
Managed Care Headlines
Massachusetts agency seeks to cover 30,000 more uninsured
Boston Globe, May 9, 2008
PA Insurance Department sets hearing for Blue Cross, Highmark deal
Philadelphia Inquirer, May 13, 2008
Minnesota governor vetoes healthcare bill
Minneapolis Star Tribune, May 14, 2008
Audit fuels criticism of IL governor on healthcare programs
Chicago Tribune, May 14, 2008
Kaiser doctors making a different kind of house call
Denver Business Journal, May 9, 2008
HMO pullouts upend Connecticut Medicaid
Wall Street Journal (subscription required), May 13, 2008
Independence Blue Cross, PA-based system agree on reimbursement contracts
Philadelphia Business Journal, May 9, 2008
Georgia governor signs high-deductible insurance plan bill
Atlanta Journal-Constitution, May 8, 2008
Advocates want safety net to catch TennCare's sickest
The Tennessean, May 12, 2008
Upcoming Events
On Demand: Legal and Tax Implications of Incentive Program Designs
On Demand: Value-based insurance design: Alternative to high-deductible plans
On Demand: Cultural Diversity and Disease Management
Listen Up
Fate of CDH
Lincoln Smith, president and CEO at Altarum Institute, a nonprofit research group that offers objective health systems research and solutions, talks about which populations benefit from consumer-driven health plans and what he sees as the future of those plans. [Listen Here]
Consumer Corner
CDHPs Can Reward and Challenge Small Firms
Small businesses are increasingly embracing consumer-driven health plans, but they face special challenges—and opportunities. Employers, brokers, and insurers could do more to ensure that these plans are implemented successfully, experts say. [Read More]
From HealthLeaders Magazine
Collect. . .or Else

HealthLeaders May 2008
A New York hospital's charge capture initiative gives the ED a financial boost. [Read More]
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Resources From HCPro

Learn how to educate and engage members.
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Discover how you can dramatically reduce costs by aggressively managing chronic disease states.
Find out how to drive behavior change through incentive plan design.
Read about pricing and capitation, cost benchmarks, utilization benchmarks, and performance and quality measures.
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