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July 16, 2008

Think Younger . . . Much Younger

Les Masterson, Senior Editor-Managed Care

Chronically ill patients, along with the implementation of programs to improve outcomes, have long been a focus for health plans when looking to trim down long-term healthcare costs. But now, some health plans are setting their sights on a new target: infants and their mothers. [Read More]

Editor's Picks
Congress easily overrides Medicare veto
Physicians have been spared for now as Congress reduced reimbursements to insurance companies involved in Medicare Advantage. The House and Senate overrode President George W. Bush's veto on a bill that would have cut Medicare doctors' fees. Instead, Congress supported cutting payments to insurance companies, which will cost the insurers $14 billion over five years. Bush criticized Congress' move, saying that Medicare Advantage gives seniors more choices and will lead to lower healthcare costs. [Read More]
Medicare auditors recover $700 million in overpayments
Auditors of a controversial program have recovered nearly $700 million in Medicare overpayments to hospitals and other medical providers. Hospitals and healthcare providers have called the program, which pays auditing firms a portion of the amounts they uncover, too aggressive and confrontational. [Read More]
Business balking at health changes in Massachusetts
Massachusetts Governor Deval Patrick's proposal to ask businesses, insurers, and hospitals to help pay for the $100 million funding gap in the health insurance law is causing grumblings from the coalition. One business lobbyist said the governor's plan "jeopardizes the support of the business community." [Read More]
House-Senate pact reached on mental health bill
Mental health coverage took a step forward as the House and Senate reached agreement on a policy framework that would require employers and health insurers to offer mental health services on par with those for physical maladies. The program is expected to cost the government $1.3 billion over five years and $3.4 billion over 10 years, mainly because of lost tax revenue. [Read More]
Low health insurance caps leave patients stranded
Americans are finding a barrier to healthcare-lifetime maximums on their health insurance. Insurers set dollar limits on care as a way to contain costs, but a number of opponents say having a $1 million or $2 million cap on health coverage is not adequate. According to The Henry J. Kaiser Family Foundation, 1% of employer-offered group plans had caps as low as $1 million last year, but 22% had caps of less than $2 million. [Read More]
BlueCross of Tennessee doctors get more time to review profiles
Doctors have 45 days to review their profiles before BlueCross BlueShield of Tennessee releases the information to allow its members to compare quality and costs of care. The online tool, which is part of the drive to offer consumers more information to make healthcare decisions, is planned to go live on Sept. 15. The Web page was planned for April, but the health insurer delayed implementation after doctors raised concerns. [Read More]
Managed Care Headlines
Doctors-insurers confrontation heats up
Dallas Morning News, July 14, 2008
Long-term fix is elusive in Medicare payments
New York Times, July 14, 2008
Administrator warns about Pennsylvania insurance merger
Philadelphia Inquirer, July 16, 2008
Anthem Blue Cross and Blue Shield, American Health Network reach accord
Indianapolis Star, July 15, 2008
Obama suggests tax credit for business healthcare
AP/Yahoo News, July 14, 2008
Private hospitals join San Francisco healthcare plan
San Francisco Chronicle, July 11, 2008
Thousands call about new Connecticut health plan
AP/Hartford Courant, July 15, 2008

Upcoming Events/Audioconferences
July 22: Health Literacy: Four Ways to Create a Successful Program
On Demand: Legal and Tax Implications of Incentive Program Designs
On Demand: Value-based insurance design: Alternative to high-deductible plans
Listen Up
Communicating Properly
Dexter Campinha-Bacote, MD, medical director at Aetna, talks about the reasons why health plans should create a health literacy program and the economic reasons that drive the need. Campinha-Bacote is taking part in a July 22 audioconference on how to create a health literacy program. [Listen Here]
Developments in DM
Workplace weight-loss programs work short-term
Workplace weight-loss programs can result in modest weight loss, but it's unclear whether patients maintain their weight-loss success or whether those successes translate into improved productivity or reduced health costs, new research shows. [Read More]
From HealthLeaders Magazine
The Politics of Healthcare
Both parties' presidential hopefuls have offered plenty of sweeping proposals for fixing the nation's healthcare ills. But will either candidate be able to follow through? [Read More]
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