HCPro Health Plan Insider - December 2, 2009 | Two Common Barriers in Medicaid—and How to Overcome Them View as a Webpage | Subscribe for Free
Two Common Barriers in Medicaid—and How to Overcome Them
Les Masterson, Senior Editor-Managed Care

Federal lawmakers will likely expand Medicaid enrollment as a way to get some of the estimated 46 million uninsured health coverage. Insurers that don't have experience in Medicaid are showing interest in getting involved in the Medicaid managed care world. They understand Medicaid is a new growth area, but there are some concerns for those without Medicaid experience. Here are two common barriers to the Medicaid population getting proper healthcare and how Medicaid managed care insurers are handling the issues. [Read More]
  December 2, 2009

Editor's Picks
Two Ways the Senate Bill Will Pay for Healthcare Reform
Health insurance companies would pick up a chunk of the tab for the Senate's $848 billion health reform bill. Insurers would pay through lower Medicare Advantage payments, taxes on so-called "Cadillac" health plans, and a net premium tax. Much of this will get transferred onto consumers through higher premiums and reduced benefits. It could also cause more insurers to abandon Medicare Advantage if they feel it's not worth it. [Read More]
Senate Reform Bill Would Expand RAC Program
RACs may be coming to health insurance in a Senate health reform bill provision that would expand the recovery audits to Medicare Advantage and Medicare Part D by December 31, 2010. Expanding this program beyond hospitals is likely—especially with the Obama administration and Democrats focused on reducing fraud and keeping an eye on Medicare Advantage. [Read More]
BCBS of Tennessee Notifying Members After Patient Information Stolen
BlueCross BlueShield of Tennessee sent a mass mailing to some of its 3.1 million customers in the Volunteer State who may have had their Social Security numbers and other private data compromised after an Oct. 2 hard drive theft at a remote training facility in Chattanooga. Meanwhile, local, state, and federal law enforcement officials have been called in to investigate the theft of three hard drives, which were physically removed from server racks on computers inside a data storage closet. BCBS of TN said the data breach is worrisome, but added the case involved an actual burglary—not an employee hitting the wrong button or putting incorrect labels on a file. [Read More]
AHA: Burden of Undercompensated Care Continues To Climb
Medicare and Medicaid underpayments to the nation's hospitals relative to the cost of care rose more than eight-fold, from $3.8 billion in 2000 to $32.4 billion in 2008, the American Hospital Association reported in its latest release of annual reimbursement fact sheets. The difference is borne by payments from health plans and other government and private payers, says Caroline Steinberg, AHA vice president for trends analysis. In turn, AHIP reported the average family of four is paying $1,500 a year in higher premiums to offset underpayments from Medicare and Medicaid. [Read More]
Managed Care Headlines
Pay-for-performance Results Lower When Productivity is the Focus
Janice Simmons, for HealthLeaders Media, November 25, 2009
10 Reasons Health Providers Give Thanks
Cheryl Clark, for HealthLeaders Media, November 25, 2009
Aetna Cutting 625 Jobs, More Expected in 2010
Les Masterson, for HealthLeaders Media, November 19, 2009
Plan to Take Away Insurers' Anti-trust Exemption Removed from Senate Bill
Les Masterson, for HealthLeaders Media, November 23, 2009
Catholic Investors Want Health Companies to Disclose Executive Pay
Cheryl Clark, for HealthLeaders Media, December 2, 2009
California Grades PPOs, None Receives Four Stars
Cheryl Clark, for HealthLeaders Media, November 19, 2009
COBRA subsidies begin expiring for the unemployed
Los Angeles Times, December 1, 2009
Health debate overlooks wellness programs
Cherry Hill Courier-Post, November 24, 2009

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From HealthLeaders Media
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Highmark Inc., has opened on-site healthcare clinics and pharmacies for its 10,000 or so employees at its two main operations centers. [Read More]
From HealthLeaders Magazine
Blocking the One-Two Punch

Health insurance companies are rightfully concerned about how healthcare reform will affect their companies and offerings, but there is a more immediate threat to their future: the loss of the employer-based health insurance market. Here are ways to survive the fading employer-based insurance market. [Read More]
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