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Shifting Costs onto Consumers May Create Long-term Problems
Les Masterson, Senior Editor-Managed Care

Shifting healthcare costs to the individual will save money in the short-term, but could have long-range cost implications if the members are not following medication regimens. There is no better example of how this cost-shifting can affect member health than high-deductible health plans. If these plans are coupled with member education and tools, they have the potential to lower costs and create more informed healthcare consumers. The problem is that high-deductible plans are often lacking in the area of member engagement and tools. [Read More]
  January 13, 2010

Editor's Picks
Physician Groups: Proposed Health Plan Tax Would Hamper Care Coordination, Raise Premiums
Health insurers have an unlikely ally in their fight against a health insurance premium tax—medical groups. The California Association of Physician Groups says that the tax would lead to less coordinated care in fee-for-service models, while hiking premium costs for the insured. The tax would only apply to health insurance companies, not to employers who self insure, and opponents say the tax would be transferred to employers and members. This could also lead employers to self-insurance, which is often fee for service and doesn't value care coordination, according to the association. [Read More]
Obama says benefits from healthcare overhaul would be immediate
Even the largest health reform proponent realizes that system changes will take years, with most of the provisions not taking effect until 2014. However, President Barack Obama is advocating the reform's immediate benefits. He said over the weekend that health reform legislation would immediately put more healthcare decision-making control into the hands of doctors and patients, would allow people with pre-existing illnesses affordable health insurance options, and provide tax credits for small businesses who can't afford to buy insurance for their employees. [Read More]
Healthcare reform bill's proposed tax on high-cost plans raises questions
Taxing high-cost health insurance plans is seen as a way to raise $150 billion over 10 years to help fund health reform. The Senate plan includes a 40% excise tax on insurance plans worth more than $23,000 per year for a family of four, while the House bill features income tax surcharges on families earning more than $1 million. There are large pockets of stakeholders and lawmakers who oppose both ideas. President Barack Obama has already promoted the idea of taxes on high-cost "Cadillac" plans. But labor and business both oppose the idea as labor believes the tax will be in effect transferred to employees and there are some Washington insiders who believe Obama is willing to compromise. [Read More]
Health bill may be lenient on employers
A strong employer mandate is unlikely to be part of the compromise healthcare reform bill, according to experts. A handful of moderate Senate Democrats, who hold the political upper hand in shaping the final bill, are expected to insist on hewing much closer to the Senate's relatively lenient approach, which does not include a strong requirement that employers offer coverage. Under the House bill, all companies with more than 50 employees would have to make substantial contributions for health insurance or face stiff penalties of up to 8% of payroll. [Read More]
Managed Care Headlines
How would a new health insurance pool work?
Los Angeles Times, January 11, 2010
Battle ensues over health insurance exchanges regulator
Wall Street Journal, January 8, 2010
Aetna calls 2010 a rebuilding year
Hartford Courant, January 13, 2010
Seven Tips to Comply with HITECH Requirements
Dom Nicastro, for HealthLeaders Media, January 12, 2010
Insurance mandate feeds GOP's attack on legal front
Wall Street Journal, January 11, 2010
Married couples pay more than unmarried under health bill
Wall Street Journal, January 7, 2010
Connecticut regulators approve double-digit health insurance increases
Hartford Courant, January 12, 2010

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What's Missing in Health Reform?

Kansas Insurance Commissioner Sandy Praeger talks about the current health reform plans, what they would mean to health insurers, and what is missing from the proposals. Praeger is also chair of the National Association of Insurance Commissioners' Health and Managed Care Committee. [Sponsored by Emdeon] [Listen Now]
Health Plan Forum
Next-Generation Analytics that Drive Better Clinical Care Decisions

Health plans are urgently seeking ways to improve quality while controlling costs. We are seeing next-generation analytics that can draw from multiple sources to meet some of our greatest challenges. We are moving into an era of information that is specific and current. Newer technologies integrate lab values and point-of-care clinical information—including data from electronic health records, writes Douglas M. Moeller, MD, medical director at McKesson Health Solutions. [Read Now]
From HealthLeaders Magazine
The Other Challenges for Health Plans

The year 2009 saw health insurers in the crosshairs in Washington as health reform made its way through the Capitol Hill sausage grinder. Health insurance executives understandably were focused on Congress and how health reform would affect their businesses, most notably reform that would shift insurers away from a risk-management business by requiring insurers to accept everyone—regardless of preexisting conditions. But while they focus on Washington, insurers face other immediate challenges. Here are issues insurers face in 2010 and how they can overcome them. [Read More]
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