HCPro Health Plan Insider - February 4, 2009 | Can a Health Plan Stall an Epidemic? View as a Webpage | Subscribe for Free
Can a Health Plan Stall an Epidemic?
Les Masterson, Senior Editor-Managed Care

As policymakers and health leaders look for ways to reduce healthcare costs through major reforms, UnitedHealthcare has created a health plan just for diabetics and pre-diabetics. [Read More]
  February 4, 2009

Editor's Picks
Administration shocked by Daschle's withdrawal
Thomas A. Daschle's withdrawal as nominee for secretary of health and human services is a political setback for the Obama administration and Democrats in Washington. For healthcare, however, Daschle's decision leads to an important question: Will it stall healthcare reform efforts in Washington this year? Though shocked by Daschle's decision, Democrats and healthcare reform advocates say they are forging ahead with plans to revamp the system. [Read More]
Managed care plans do little to rein in costs
Health insurers are not containing healthcare costs, according to a recent study. In fact, private Medicare Advantage plans do not avoid any more unnecessary surgeries than the traditional fee-for-service Medicare system. The study's author says insurers share some blame in escalated healthcare costs because they are not effectively using their resources, pre-approval protocols, and existing published guidelines to prevent overuse of unnecessary and costly procedures. [Read More]
Skyrocketing costs could double premiums
Most Americans will pay double the amount for their health insurance premiums by 2016 unless there are major healthcare reforms, according to a new report by the Public Interest Research Group. Wasteful spending and inefficiencies will push the costs of employer-paid health insurance to more than $24,000 annually in the next seven years, PIRG predicts. [Read More]
Aetna settles billing case with students
Another week brings another health insurance settlement. This time Aetna agreed to pay more than $5.1 million to reimburse more than 73,000 college students for out-of-network underpayments. The resolution ended an investigation by the New York Attorney General's Office that found Aetna underpaid student health insurance claims between 1998 and April 2008. Aetna will also hire an independent third-party examiner to review the unit's compliance and training procedures. [Read More]
Blue Cross asks Michigan to hike rates
Faced with $1 billion in expected loses over the next two years, Blue Cross Blue Shield of Michigan wants to raise the rates of 400,000 individual health insurance members. Blue Cross' request to the state would increase individual plans by an average of 56% and Medicare plans by more than 30%. In addition to the rate increase request, the insurer plans to lay off as many as 1,000 employees, freeze some executive salaries, and cut spending. Michigan Attorney General Mike Cox and a consumer coalition oppose the rate hikes. [Read More]
Managed Care Headlines
House set to pass kids' health bill
AP/Yahoo News - February 4, 2009
WellPoint profit slides 61% as plan numbers drop
Wall Street Journal - January 29, 2009
With merger off, Pennsylvania Blues refocus attention
Philadelphia Inquirer - February 2, 2009
Dueling health plans in Pennsylvania
AP/Philadelphia Inquirer - February 3, 2009
The new uninsured
Washington Post - February 3, 2009
Connecticut's HUSKY members may struggle to see doctors
Hartford Courant - February 2, 2009

Webcasts/Audio conferences
February 12: Incentive-Based Compensation Plans to Enhance Physician Performance
February 20: ED Overhaul 2009: Five Improvements to Make Today
February 24: Form 990H: Act Now to Protect Your Reputation
From HealthLeaders Media
Healthcare Hunkers Down
to Weather Storm

We've been talking for months and years about a shortage of nurses and other healthcare workers. Well, that may change—at least for the short term. [Read More]
Guest Commentary
Where's the Value in Healthcare?

Patients today seek healthcare information and treatment from a variety of sources like health information Web sites, social networks, and the more traditional physician office. HealthLeaders Media contributor John Morrow offers five strategies that healthcare executives can use to better demonstrate their organization's value to these newly empowered consumers. [Read More]
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