HCPro Health Plan Insider - September 10, 2008 | Fixing a Broken System View as a Webpage | Subscribe for Free
Fixing a Broken System
Les Masterson, Senior Editor-Managed Care
Some in disease management/population health are worried that the medical home will make their services unnecessary, but healthcare experts say there are great opportunities for DM and population health in the medical home. Primary care practices will need DM and population health companies for patient registries, 24/7 nurse help lines, and care coordination programs. [Read More]
  September 10, 2008

Editor's Picks
CA enacts no major overhaul, OKs key changes
The huge healthcare reforms batted around in California over the last two years did not come to fruition, but legislators were able to pass legislation on health plans' rescission policies, clamp down on balance billing, require insurers to spend at least 85% of their premiums on medical care rather than overhead and profits, mandate insurers to cover certain care and equipment, and create a government office to protect patient privacy. The state Senate had earlier rejected Gov. Arnold Schwarzenegger's $14.9 billion healthcare reform plan. A Democratic leader in the Senate says healthcare will be a priority in the next session. [Read More]
Cutting health costs encourages chronic disease management
A Virginia hospital and public school system are experimenting with lowering employee costs for some chronic disease medications and providing free counseling for depression. The idea, called value-based insurance design, has been found to be effective in improving medication compliance. [Read More]
Shopping for healthcare off to a shaky start
Though there is greater emphasis on individuals making healthcare choices, online information to help consumers make those decisions is limited. One particular area of concern is that those shopping for individual insurance do not have adequate information to make educated decisions. [Read More]
WellCare reverses course, sticks with Florida Medicaid reform
WellCare Health Plans Inc., has decided to stick with the Florida Medicaid program after all. WellCare has decided to continue with its two Medicaid plans, HealthEase of Florida Inc., and Staywell Health Plan after initially announcing it was going to bow out of the managed care Medicaid experiment in Broward and Duval counties. [Read More]
Managed Care Headlines
Study: Workers to pay more for healthcare
AP/Yahoo News, September 4, 2008
Massachusetts could be sued, healthcare giant warns
Boston Globe, September 8, 2008
Humana to lose some Medicare enrollees
Wall Street Journal (subscription required), September 10, 2008
Collaborative offers toolkit to tackle disparities
Robert Wood Johnson Foundation, September 9, 2008
Group seeks end to gridlock on health reform
Reuters/Yahoo News, September 9, 2008
Judge trims time in Medi-Cal 10% fee ruling
San Francisco Chronicle, September 4, 2008
Rhode Island seeks limits on Medicaid spending
Washington Post, September 5, 2008
Obesity surgery is called cost-effective
Wall Street Journal (subscription required), September 9, 2008
Alabama lawmakers approve weight-loss extension
Birmingham News/Huntsville Times, September 5, 2008

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From HealthLeaders Media
Where Do You Stand on ICD-10?

The government's proposed three-year timeline to replace the ICD-9-CM code sets with ICD-10-CM code sets is causing a stir among some in the medical community. [Read More]
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