HCPro Health Plan Insider - March 4, 2009 | Mr. President, Use the Scalpel View as a Webpage | Subscribe for Free
Mr. President, Use the Scalpel
Les Masterson, Senior Editor-Managed Care

By cutting payments to special needs plans, the president is in effect decimating programs that could ultimately be the best way to care for the highest-cost beneficiaries. [Read More]
  March 4, 2009

Editor's Picks
Obama Budget Would Reform Healthcare
President Barack Obama's $3.1 trillion budget will mean big changes for the healthcare system. HealthLeaders Media senior editors have been delving into the changes: Elyas Bakhtiari and John Commins explore the proposal and the $630 billion healthcare reform reserve fund, and Philip Betbeze wrote about how the budget proposal calls for a switch to bundled payments for Medicare beneficiary hospitalizations.
Tufts Health Plan CEO: Build On Employer-Based Healthcare Model
Sometimes it pays to live in Massachusetts. Sure, the taxes are too high, the winter stinks, and the largely one-party political system is rife with problems, but on the plus side the Bay State is the epicenter of healthcare reform and a hub of healthcare knowledge. I attended the Transforming Healthcare event last week where healthcare leaders provided their takes on national healthcare reform, the stimulus package, and the Massachusetts model. [Read More]
Kansas governor accepts offer as health secretary
President Barack Obama ultimately decided to go with someone without Washington experience as his choice for secretary of health and human services. Kansas Gov. Kathleen Sebelius, who was rumored for the job since initial nominee Thomas Daschle withdrew his nomination last month, is a two-term governor and former state insurance commissioner. Her supporters say she can work with Republicans, but the question is: Can she work with Washington Republicans? Though Sebelius has been touted as the front runner since Daschle stepped aside, I am still surprised that Obama ultimately chose her. I thought he would select a Washington insider, who understands the town and already has connections to the capital's inner workings. As President Bill Clinton learned, having an outsider lead your healthcare reform effort can result in disaster. [Read More]
Healthcare reform package could come by summer
A leader in the healthcare reform movement on Capitol Hill, Sen. Max Baucus, plans to introduce healthcare reform legislation sometime between June and August. The chairman of the Senate Finance Committee expects to introduce a bipartisan bill with Republican Sen. Charles E. Grassley that would adopt a mix of public and private solutions. Baucus said he supports a plan similar to President Barack Obama's and the Massachusetts reform idea. Though he seeks universal coverage, he does not want a single-payer system. Baucus' statement is the latest to show that support for single-payer healthcare has waned in Washington. [Read More]
Medicare spending still varies widely by region
Addressing the wide variations paid by Medicare to doctors across the country will be a critical part of healthcare reforms, according to a new analysis by Dartmouth researchers. Some regions, such as Miami and Dallas, are experiencing faster growth in costs than areas like San Francisco and Pittsburgh. The differences in costs are often linked to doctors ordering more tests and admitting more patients to hospitals. Areas that have more hospital beds and sophisticated imaging equipment are the regions that see the highest costs. One way to resolve this problem is to stop paying doctors for volume and intensity and instead reward doctors for providing better care. [Read More]
Blue Cross, Seattle doctors battle over payment rate
In an especially heated disagreement over payment rate, Premera Blue Cross and Proliance Surgeons, one of the largest surgical practices in Seattle, have taken their fight publicly. Proliance Surgeons, which includes orthopedists and otolaryngologists, pulled out of Premera's provider network in August after the insurer reportedly asked for the group to take a 6% payment cut while the surgeons sought a 5% increase. Premera said it asked for the cut because Proliance is paid 20 to 40% higher than other area practices. This battle could be a harbinger of things to come as payment reforms look to increase primary care physicians and decrease pay to specialists. [Read More]
Caritas bids to join Massachusetts network of health insurers
The second-largest healthcare system in New England is exploring a new health insurance program that could add another option for low-income Massachusetts residents. Caritas Christi Health Care and St. Louis-based Centene Corp., which works with Medicaid populations, created a new venture called Commonwealth Family Health Plan, which is one of the proposals offered to the Massachusetts Connector Authority Board, the group that oversees the state's universal healthcare program. The new venture was the lowest bidder of five proposals. But there may be a catch. One board member said she is concerned about Caritas' venture because the six-hospital network is affiliated with the Boston Archdiocese and does not perform abortions. Will ideology hamper Caritas' plan? [Read More]
Managed Care Headlines
Insurers poised for round two of health reform
New York Times - March 2, 2009
Jobless, or about to be, and rushing to use medical benefits
Hartford Courant - March 2, 2009
Attacks mount on preexisting conditions
Philadelphia Inquirer - February 26, 2009
Rising costs prompting small businesses to drop health benefits
Chicago Tribune - February 26, 2009
Bill would limit funding for Florida's Medicaid pilot
AP/Miami Herald - March 3, 2009
In auto talks, no cure-all for healthcare costs
Washington Post - February 27, 2009
Oklahoma House passes healthcare bill
AP/USA Today - March 4, 2009
HSAs catching on in Minnesota
Minneapolis Star Tribune - February 26, 2009
Insurers provide relief for osteoporosis patients
Chicago Tribune - February 26, 2009

Webcasts/Audio conferences
March 16: Solving Your Nurse Shortage: Long-Term Strategies That Work
March 20: 5 Ways to Improve the Patient Experience at Your Hospital
On Demand: ED Overhaul 2009: Five Improvements to Make Today
On Demand: Form 990H: Act Now to Protect Your Reputation
From HealthLeaders Media
Economic Stimulus Coverage
The biggest healthcare story of 2009 so far has been the stimulus package and the $150 billion headed to healthcare. Though there is little money going directly to health insurers, the package includes Medicaid funding, COBRA premium help, health IT, and prevention, which will affect insurers indirectly. HealthLeaders Media and HCPro have covered the stimulus package extensively over the past two weeks. [Read More]
No Debate: Patients = Consumers
Embracing consumerism is becoming one of those "get over it" moments for healthcare professionals. You can resist the notion all you want; the fact is patients more and more see themselves as consumers, writes HealthLeaders Media Editor Rick Johnson. [
Read More]
Listen Up
Industry Survey 2009:
HealthLeaders Editor Round Table

HealthLeaders Media Editors react to the findings of the Industry Survey 2009. [Listen Now]
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