HCPro Health Plan Insider - June 10, 2009 | Public Plan Would Stifle Innovation. Or, Would It? View as a Webpage | Subscribe for Free
Public Plan Would Stifle Innovation. Or, Would It?
Les Masterson, Senior Editor-Managed Care

Private insurers are on the verge of possible destruction. How they respond to the issues tearing down the industry will be a major factor in whether private insurance remains. It's time to get innovative people. [Read More]
  June 10, 2009

Editor's Picks
Healthcare Reform Bill Includes Insurance Requirement, Exchanges, Greater Industry Oversight
The Senate Health, Education, Labor and Pensions Commission, chaired by Sen. Edward Kennedy, released a bill called "Affordable Health Choices Act" that gives us a glance of where the healthcare reform could go over the next few months. The bill would require all Americans to have insurance, create new insurance exchanges to provide near universal coverage, and increase government oversight of the insurance industry. One area not featured in the bill is the public insurance option, which many Republicans oppose, but the GOP, who feel they are being ignored, are still not pleased. [Read More]
Limiting Employer Tax Exclusion May Help Pay for Health Reform
How is Congress going to fund comprehensive healthcare reform? One recent study suggested lawmakers may find it difficult to finance universal coverage unless it limits to some extent the exclusion of employers' health insurance payments from employees' income and payroll taxes. The current exclusion is poorly designed, which gives the greatest benefit to those with higher incomes, according to the report. The report added that the exclusion can actually incentivize employers and patients to select more generous and costly coverage. Even so, if cutting the exclusion becomes part of a major reform package, expect major opposition from employers and unions. [Read More]
Obama's Vision of Public Plan Takes Shape
President Barack Obama supports "shared responsibility" when it comes to a public insurance option, including an individual mandate. The president, who hopes to have a healthcare reform bill signed by October, said his $2.5 trillion reform package would be funded partly through strengthening Medicare and Medicaid payment accuracy, improving care after a patient was hospitalized, and eliminating fraud, abuse, and waste. He said his estimated savings were about $309 billion. That still leaves a lot of money that lawmakers will have to find. [Read More]
AHA and AMA Ask Health Plans: Can't We All Just Get Along?
Top officials for the American Medical Association and the American Hospital Association agreed that they should set aside their long adversarial history with health plans and work together, not for their own bottom lines, but to improve the health of their patients by adhering to comparative effectiveness research. Speaking at America's Health Insurance Plans conference, Nancy Nielsen, MD, president of the AMA, said AMA officials will announce a major cooperative effort with a health plan to work on a comparative effectiveness research project in one state. [Read More]
Ex-Governors Spar Over The Role of a Public Plan
Three former governors argued about what role federal money should play in health reform during America's Health Insurance Plans' conference last week. Former governors Howard Dean, MD (Vermont), Jeb Bush (Florida), and John Kitzhaber, MD (Oregon), agreed that the current system is functionally flawed. And they agreed that health plans, employers, and consumers need to take more responsibility for their own healthcare. But they disagreed on how much of a role the government should play, and whether any level of its regulatory presence would stifle innovation to improve the delivery of medicine. [Read More]
Double-digit Rate Hikes Projected for Health Plans
Many popular private healthcare plans that cover nearly 100 million Americans will see double-digit rate increases into 2010, according to a national survey of more than 100 health insurers, HMOs, and third-party administrators. Buck Consultants found that costs for the most popular plans continue to increase by more than 10%, and are slightly lower than the trends reported in Buck's most-recent September 2008 survey. Buck officials predict healthcare costs will most likely experience higher increases after years of smaller increases. [Read More]
Managed Care Headlines
2008 a down year for managed care, 2009 looks a little better
John Commins, for HealthLeaders Media - June 3, 2009
State coverage model no help for uneasy insurance industry
New York Times - June 8, 2009
Kennedy details vision for healthcare
Washington Post - June 8, 2009
Private insurance companies push for individual mandate
Los Angeles Times - June 8, 2009
Republicans complain about plan for health insurance
New York Times - June 8, 2009
Medical bills play a role in 62% of bankruptcies, study says
Los Angeles Times - June 4, 2009
Hoping to Prevent Scams, State May Require Licensing of Discount Health Plans
Cheryl Clark, for HealthLeaders Media - June 9, 2009

Webcasts/Audio conferences
July 22: Service Line Strategies Workshop 2009: Spine Care
June 17: HIPAA Changes: New Compliance Strategies for New Marketing Models

Listen Up
Finding ROI in DM Programs

Health plans are increasingly interested in whether disease management programs are producing positive ROI especially in this tough economy. In this podcast, Siva Namasivayam, chief executive officer at SCIOinspire, and Timothy Cahill, senior vice president of business development at SCIOinspire, speak about the best ways to gauge ROI for DM programs. [Read More]
Health Forum
Making Consumer Incentives Work in a Care Management Program

Consumer incentives are often thrown around as healthcare panacea. Send out a few gift cards and watch program enrollment increase as members lose weight, quit smoking, and generally improve their health as bad habits are eliminated. However, the incentive isn't a silver bullet. [Read More]
From HealthLeaders Magazine
Wellness Goes Global

The struggling economy is forcing many U.S. employers to review their health offerings, which is leading health insurers and population health companies to look beyond this country's borders to help offset possible losses. [Read More]
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Resources From HCPro

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