HCPro Health Plan Insider - February 18, 2009 | Avoid the Garbage View as a Webpage | Subscribe for Free
Avoid the Garbage
Les Masterson, Senior Editor-Managed Care

Physicians often ignore communications from health insurers, but a combination of targeted outreach coupled with patient engagement could improve patient compliance with appropriate tests and medications. [Read More]
  February 18, 2009

Editor's Picks
Stimulus Bill Provides $150 Billion for Healthcare
Although the $787 billion stimulus bill signed by President Barack Obama Tuesday may not impact health insurers immediately, the package will have longer range effects on health IT and connectivity, Medicaid, and evidence-based medicine, which is a favorite of America's Health Insurance Plans. The bill includes $150 billion in healthcare expenditures, including $19 billion for health IT, $87 billion for Medicaid programs, $19 billion for helping unemployed Americans with COBRA premiums, and $1.1 billion to collect data on evidence-based medicine. Given the breadth of this landmark legislation, HealthLeaders Media and HCPro colleagues looked into how the stimulus bill will affect healthcare: John Commins writes about how the bill looks to spend money on healthcare now to save for tomorrow. Dom Nicastro explores how the bill toughens the HIPPA law, and Lisa Eramo writes about the stimulus bill's affect on emergency medical records.
Health Net agrees to settle rescission lawsuits
Health Net is the latest California health insurer to agree to pay a large sum to settle lawsuits connected to former members whose coverage was dropped because of expensive medical care. The insurer has agreed to pay as much as $14 million to settle the lawsuits, which follows a $26 million payment to the state because of rescission policies. Health insurers say rescissions are a necessary evil in the individual market, but those policies have been under attack. America's Health Insurance Plans, in its healthcare reform proposal, even proposes the end of rescissions, but wants to require all Americans have health insurance so there is a large enough care pool to help fund caring for the sickest. [Read More]
Two insurers charging beyond last-resort coverage max
What is it with California? There is a steady stream of news coming from The Golden State about health insurers that make the Big 3 automakers look like choirboys. In this latest black eye for insurers, two of the state's largest insurers have been charging members for safety net coverage beyond the state-issued rates. Blue Shield of California's premiums are as much as 55% higher and Anthem Blue Cross is charging as much as 36% higher than the state limits. The rates affect more than 13,000 people with Anthem coverage and more than 6,000 with Blue Shield policies. One has to wonder why there is so much negative health insurance news coming from California. Is it because the newspapers, activists, and officials are keeping a closer watch on insurers or does the state's political/business climate lead to these problems? [Read More]
Cigna settles over out-of-network payments
Cigna Corp., is the latest health insurer to reach an agreement with New York in the wake of the Ingenix case. The state's attorney general's office questioned how much insurers were paying doctors and hospitals for out-of-network medical care, which was figured out by reviewing figures compiled by Ingenix, owned by insurer UnitedHealth Group. In this latest settlement, Cigna will contribute $10 million to a new, independent database that will calculate how much they should pay for doctors and hospitals outside of their networks. The insurer is the third to reach an agreement with the state of New York. [Read More]
At Wal-Mart, a healthcare turnaround
Once criticized for lacking employee health benefits, Wal-Mart has extended coverage to more employees while other employers have dropped benefits to cut costs. Nearly 95% of the retail giant's employees now have health insurance, compared to the national average of 82%. The company has a number of health initiatives, including electronic health records, expanded cheaper generic drug alternatives, wellness programs, and premature birth prevention. That's the good news. On the flip side, Wal-Mart's low-wage workers pay a large portion of their income on medical coverage. [Read More]
Young adults and consumerism are a match
Twenty-somethings are forgoing healthcare coverage—even those who can avoid insurance. Blogger Mark Reiboldt says Gen Y'ers need to make safer decisions that could impact them down the road. One example of how Gen Y'ers can get coverage is through consumer-driven health plans, he writes. [Read More]
Managed Care Headlines
HHS vacancy stalls health agenda, advocates say
Washington Post - February 17, 2009
For uninsured young adults, do-it-yourself healthcare
New York Times - February 18, 2009
Financial problems for Aetna
AP/Hartford Courant - February 12, 2009
Healthcare coalition rises, then stalls
Yahoo News - February 17, 2009
GM presses union for cuts in healthcare
New York Times - February 17, 2009
Healthcare watchdog on the chopping block in Connecticut
Hartford Courant - February 12, 2009

Webcasts/Audio conferences
February 20: ED Overhaul 2009: Five Improvements to Make Today
February 24: Form 990H: Act Now to Protect Your Reputation
March 16: Solving Your Nurse Shortage: Long-Term Strategies That Work
From HealthLeaders Media
HealthLeaders Survey Results
Show Disconnect

HealthLeaders Media' Industry Survey is an annual glimpse into the healthcare industry across multiple areas. This year, we included health plans/managed care in the survey, and what we found was fascinating. We created a Web page that highlights the findings for each of our surveys, which allows readers to see what thought leaders from various segments of healthcare think. The most interesting findings for me pertained to comparing physicians with health plans. As would be expected, health plans and physicians don't agree on much, including pay-for-performance programs, reimbursement, and how to improve payer/physician relations. Check it out for yourself. [Read More]
From HealthLeaders Magazine
The CDHP Trickle

A lack of consumer understanding has contributed to the glacial growth of consumer-driven plans. Can better information from health plans help CDHPs take hold? [Read More]
Sponsor Health Plan Insider

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