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White House May Push Health Plans to Create Wellness Programs
Joe Cantlupe, Senior Editor-Managed Care

First Lady Michelle Obama is taking on a bloated nation and health insurers may one day have to help. Health plans are now trying to fight obesity voluntarily with wellness, fitness, and disease management programs, but those offerings could become mandatory as the nation searches for ways to reduce health costs. Will insurer programs help pare the pounds? [Read More]
  February 3, 2010

Editor's Picks
Medicare Advantage Benefits, Cost-Sharing Requirements Vary Greatly, says Report
The benefits and cost-sharing requirements of the Medicare Advantage plans that serve 10 million Americans vary widely from plan-to-plan with little explanation for the variance, a new Kaiser Family Foundation study finds. The analysis examines trends in benefits and cost-sharing for Medicare Advantage plans, including HMOs, PPOs, and private fee-for-service plans. It found that Medicare Advantage enrollees could pay between zero and $3,325 for a five-day inpatient hospital stays, depending upon where they live and the plan they select. [Read More]
Cardiologists battle Medicare over payment cuts
A group of South Miami cardiologists has written a letter to patients complaining that huge cuts in Medicare rates may force many heart specialists out of business or mean reduced services for their patients. The doctors from South Miami Cardiology said that on Jan. 1 Medicare reduced "reimbursement for cardiac services on average by 40%." This is unrelated to the current healthcare reform, which is planning an additional 21% reduction, effective March 1. Lori Heim, president of the American Academy of Family Physicians, says that she finds it "disingenuous" that the cardiologists' letter blames reform proposals for their rate cuts. [Read More]
Most Congresspeople in Districts with Highest Uninsurance Rates Support Reform
All nine House Democrats whose districts represent areas in the 10 highest uninsured rates in the nation voted for the healthcare reform bill. One Republican in the top 10 uninsured districts voted against the plan, still being debated in Congress. Rep. Gene Green, a Texas Democrat, said he didn't have much choice but to vote for the House's health reform bill, because 43% of Green's constituency in the Houston area doesn't have health insurance, the highest of any congressional district in the nation. Green's 29th district is nestled in a state that has the highest uninsured rate in the country. [Read More]
Insurer Survey Projects Double-Digit Health Plan Cost Increases in 2010
A survey of insurers projects the cost of employer-provided health plans will increase at a "double-digit" rate in 2010. In its 21st National Health Care Trend survey, Buck Consultants found that costs for the most popular medical plans are projected to increase by more than 10% and are in line with previous trends. “Health insurers are concerned about higher costs due to federal mental health parity, as well as an increase in COBRA enrollment,” said Harvey Sobel, a Buck principal and consulting actuary who directed the survey. [Read More]
Live ED Overhaul Webcast on February 23
Join HealthLeaders Media on February 23 for HealthLeaders Media Rounds: ED Overhaul: Reduce costs, improve quality, and increase satisfaction from 9 a.m.-noon, PST. This three–hour Webcast features discussion–including interactive Q&A–of the key issues impacting ED management. Hear top executives from Scripps Health, Tomball Regional Hospital, William Beaumont Hospital, and Methodist Healthcare share solutions to: crowding and wait times, streamlining the admission process, ED and hospital integration, staffing plans that reduce costs and increase coverage during peak hours, physician alignment, and quality and patient safety improvement. For more information and to register click here. To attend the program live on the Scripps La Jolla campus, click here.
Managed Care Headlines
Obama Supports Parts of GOP Congressman's Health Reform
Janice Simmons, for HealthLeaders Media, February 2, 2010
Obama's Proposed Budget: More Money for Health IT, Medicare, Medicaid, NIH
Janice Simmons, for HealthLeaders Media, February 1, 2010
Blue Cross Blue Shield of Texas setting up medical home program
Dallas Morning News, February 2, 2010
Changes would add costs to IowaCare, official says
DesMoinesRegister.com, February 3, 2010
Healthcare overhaul still on table
Wall Street Journal, February 2, 2010
HHS' Mental Health Interim Rules Create Benefit Parity
Janice Simmons, for HealthLeaders Media, February 1, 2010
States restart healthcare push
Wall Street Journal, February 2, 2010
Democrats quietly working to resuscitate healthcare overhaul
Los Angeles Times, February 1, 2010

Webcasts/Audio conferences
February 23: ED Overhaul: Reduce costs, improve quality, and increase satisfaction
On Demand: Joint Replacement Service Lines: Alignment and Business Strategies for a Changing Environment
On Demand: Service Lines Strategies Workshop 2009: Stroke Care
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Audio Feature
Tips to Avoid Claims Denials

Judy Suska of IMA Consulting offers hospitals tips on working with health plans on claims denials. [Sponsored by Emdeon] [Listen Now]
Audio Feature
Which Health Reform Provisions Will Pass This Year?

Ned Moore, CEO of Portico Systems, talks about health reform in light of Scott Brown's recent election win in Massachusetts. [Sponsored by Emdeon] [Listen Now]
From HealthLeaders Media
Is Steele the Man for CMS?

The rumor mill has President Obama naming Geisinger Health System CEO Glenn Steele as the new chief of the Centers for Medicare and Medicaid Services, a position that has been vacant since before the Bush administration left office. People have been wondering what Obama has been waiting for, and some assumed he was thinking Congress would pass a health reform bill that a new director could help implement. That justification doesn't hold much water for Senior Leadership Editor Philip Betbeze. [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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