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Is Self-Management the Future of DM?
Les Masterson, Senior Editor-Managed Care

The healthcare system does not prevent illness and disease, and empowering the individual patient to take control of his or her health could become the next frontier for disease management. There are a whole slew of barriers to overcome if chronic illness self-management is to become the norm though. [Read More]
  December 3, 2008

Editor's Picks
Consensus emerging on universal healthcare
Change is in the air in Washington and healthcare reform may soon become a reality. Stakeholders agree that government intervention is warranted to create universal coverage, but rather than a federal, single-payer system or a greater reliance on individual insurance, leaders seek to maintain the country's employer-based system. Another emerging consensus is a greater focus on reducing costs and rewarding quality. [Read More]
Economy likely to move up Medicare's insolvency
The Medicare trust fund that covers hospital and nursing home care will become insolvent sooner than expected, according to federal health officials. The sputtering economy will speed up insolvency to between 2016 to 2018. [Read More]
A fee change by Blue Cross/Blue Shield cuts deep
Blue Cross/Blue Shield federal employee program enrollees who choose the company's standard option next year will have to pay 100% for an operation by out-of-network physicians, up to a maximum of $7,500 per surgeon, per surgical day, according to the plan's Service Benefit Plan. Federal employees in that plan currently pay 25% of what Blue Cross sets for a procedure, plus any difference between that and the billed amount. The insurer says the change "protects the members upfront" by informing them of their maximum out-of-pocket expense. [Read More]
Studies: private Medicare plans have added costs, for little gain
Opponents of Medicare Advantage plans received more ammunition in their hopes to severely cut the private Medicare programs. The plans, which cover nearly one-quarter of Medicare beneficiaries, have increased costs without improving care, according to researchers. The federal government pays private insurers 13% more on average for Medicare Advantage than it would spend for the same beneficiaries in traditional Medicare. President-elect Barack Obama and the Democratic-led Congress are expected to make major cuts to the Republican-backed program in 2009. [Read More]
Managed Care Headlines
Seniors face gap in health insurance
The Tennessean - December 1, 2008
Discount healthcare?
Miami Herald - December 1, 2008
A third of Medicare clients unfamiliar with benefits
HealthDay/Washington Post - November 26, 2008
UnitedHealth Group, Inc. jumps into Web
Wall Street Journal (subscription required) - December 1, 2008
Managed healthcare plan unveiled for Louisiana's poor
New Orleans Times-Picayune - December 2, 2008
Blues, Michigan AG continue health insurance fight
AP/Chicago Tribune - December 2, 2008
Connecticut officials reach truce in healthcare plan dispute
Hartford Courant - November 26, 2008
Florida's number of uninsured children climbs
AP/Miami Herald - December 1, 2008`

Events/Audio conferences
December 16: What Your Practice Is Worth: Calculating Fair Market Value
On Demand: 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: Value-based insurance design: Alternative to high-deductible plans
Listen Up
Device Dysfunctionality
John Bardis, chairman, president and CEO of MedAssets, discusses a variety of issues facing healthcare, not the least of which is the cost equation, which is unsustainable long term. Bardis also talks about the dysfunctional economy, his challenges in running a now-public company, and the institutionalized lack of transparency in medical device pricing, which he believes leads to irrational high costs in healthcare. [Listen Here]
Guest Commentary
Opportunities in the Medical Home
The medical home model seems like a natural progression toward effective care collaboration. As this care model has progressed from the government to the commercial space, some organizations fear that the need for their services will diminish rather than flourish. Realistically, there will be a continued place for them in the medical home, writes contributor Jo Anne Hunt. [Read More]
From HealthLeaders Magazine
The Big Keep Getting Bigger

Some major changes afoot for health insurance companies in the eastern United States have intensified concerns about the implications for the broader managed care landscape—and whether the next step is an industry ruled by a handful of insurance giants. [Read More]
Sponsor Health Plan Insider

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Resources From HCPro

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