HCPro Health Plan Insider - October 29, 2008 | DM's Future is in Technology View as a Webpage | Subscribe for Free
DM's Future is in Technology
Les Masterson, Senior Editor-Managed Care

Disease management leaders know that the only way DM can work is if technology is integrated into their programs. DM/population health is no longer considered the enemy by forward-thinking physicians and health leaders. Instead, they realize that DM can be an effective member of the care team. [Read More]
  October 29, 2008

Editor's Picks
Doctors and insurers blame each other for administrative headaches
Doctors and insurers are pointing at each other as the reason for billing disputes and payment delays. Doctors and hospital executives say collecting payments from insurers is driving up the nation's healthcare costs, while insurers claim they are just ensuring that doctors treat patients at high-quality standards consistently and not waste money on overused treatments and unnecessary tests. [Read More]
Medicare officials to review insurers' commissions
Federal health officials plan to investigate commissions given to agents and brokers involved in Medicare Advantage programs. Those who question the bonuses say the incentive may push agents to lead the elderly and disabled into the program. The investigation comes the same month CMS implemented new regulations designed to curb abusive sales tactics. Medicare Advantage programs, which are offered by private insurers that receive government subsidies, enroll about 10 million Americans. [Read More]
California high-risk pool for medically uninsurable helps fewer residents
A mere 2% of those deemed "medically uninsurable" in California are covered under the Major Risk Medical Insurance Program, which helps those who have been rejected by commercial insurers. Enrollment has dropped by nearly a third since Gov. Arnold Schwarzenegger took office, though the governor says helping the uninsured is at the top of his agenda. Last month, Schwarzenegger vetoed a proposal that would have expanded the pool and said the healthcare system needs a complete overhaul. [Read More]
Massachusetts insurer wants to write off prescription pads
Blue Cross and Blue Shield of Massachusetts is not waiting for CMS to begin paying doctors to e-prescribe. The state's largest health insurer will pay bonuses to physicians who e-prescribe in 2011, a year before CMS is starting its incentive program. Supporters say e-prescribing reduces medication errors and drug interactions, and reduces overall costs. BCBSMA has been at the forefront of the e-prescribing movement. [Read More]
Disney's employee clinic like no other
If Mickey Mouse's blood pressure or cholesterol become a problem, the famous mouse will have a place to receive care without leaving the Magic Kingdom. The Walt Disney World Center for Living Well, an employee medical clinic for its 41,000 eligible full-time employees and their families, recently opened its doors. The center will offer a variety of medical and wellness services and resources. The facility is staffed with primary care physicians and nurses, and provides a full-service pharmacy, urgent care, lab facilities, digital-radiology services, and behavioral health services. [Read More]
Medical costs in Massachusetts still burden many despite insurance
Despite living in the most insured state, many Massachusetts residents are still struggling with medical costs, causing some to postpone treatments and not fill prescriptions, according to a study. Thirteen percent of insured people surveyed said they were unable to pay for some health services in the past year and the same percentage said they did not fill at least one prescription because of costs. [Read More]
Managed Care Headlines
Bailout seen hitting Obama, McCain health plans
Reuters/Yahoo News - October 23, 2008
McCain's proposal for high-risk coverage is similar to a program in Minnesota
Washington Post - October 29, 2008
Obama's approach emulates Massachusetts' except for mandate on covering all adults
Washington Post - October 29, 2008
Health-coverage plans could face obstacles from growing budget gap
Wall Street Journal (subscription required) - October 27, 2008
Cigna rolls out posh health plans for individuals and small businesses
Wall Street Journal (blog) - October 29, 2008
Kennedy focuses from home on healthcare overhaul
AP/Yahoo News - October 27, 2008
Humana hit hard
Forbes - October 28, 2008
CT governor postpones shift to Charter Oak plan
Hartford Courant - October 24, 2008
Health plan initiative is sacrificed to shore up Washington, DC, funds
Washington Post - October 29, 2008

Events/Audio conferences
November 3: Financial Meltdown: Managing Through The Crisis
On Demand: In-sourcing vs. Outsourcing Disease and Health Management: What's the Right Mix
On Demand: 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
How Population Health Helps in the Medical Home
Tracey Moorhead, president and CEO of DMAA: The Care Continuum Alliance, discusses the opportunities for population health improvement and disease management companies in a medical home and the changes those companies will need to make to contract with physicians rather than health plans. [Listen Here]
From HealthLeaders Media
American Medical Tourism: Fact vs. Fiction
There's no shortage of reporters, consultants, and others who want to convince us that outbound medical tourism from the U.S. is a rapidly emerging trend. [Read More]
From HealthLeaders Magazine
Model for Success

Running a medical group has never been more complex. But many practices have found ways to not only survive?but thrive. [Read More]
Sponsor Health Plan Insider

Contact Lisa Brown, Director of Integrated Sales, at lbrown@healthleadersmedia.com or call 781.639.1872.
Resources From HCPro

Learn what's the right mix of disease management programs for your company.
Find out how health literacy affects your members.
Discover how to integrate wellness into your DM programs.
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Read about practical strategies for maximizing the effectiveness of health and disease management programs.
Learn how to educate and engage members.
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