HCPro Health Plan Insider - February 10, 2010 | Empowering Consumers Will Make Value-Based Programs Work View as a Webpage | Subscribe for Free
Empowering Consumers Will Make Value-Based Programs Work
Joe Cantlupe, Senior Editor-Managed Care

Many health plans are unsure about the future and are searching for answers. The news isn't always good. Health plans are under constant pressure to be more affordable yet more efficient. But so much really depends on the members themselves. Health plans have their fingers crossed as they try to stem the tide of overwhelming healthcare costs, with or without help from Washington, says Jan Berger, MD, chief medical officer for Silverlink Communications Inc. [Read More]
  February 10, 2010

Editor's Picks
Sebelius Lashes Out at Anthem for Premium Increases
Anthem Blue Cross raised its individual member premiums. Health and Human Services Secretary Kathleen Sebelius is demanding that insurer publicly justify it. In a letter to Leslie Margolin, president of Anthem Blue Cross, California's largest for-profit insurer, Sebelius bashed the premium increases at a time when WellPoint, Anthem's parent company, "earned $2.7 billion in the last quarter of 2009." She said, "This announcement reminds us that too many Americans can be left with unaffordable insurance each time the rates or rules change in the private market." Anthem Blue Cross proposed to increase the premiums on March 1. The Los Angeles Times reported that those premium increases were as high as 39%. [Read More]
Health Insurers Need to Focus on Climate Change
Potential climate change litigation affecting insurers may be just beginning. A potential flood of lawsuits "will pose a challenge" especially because of demands for insurance carriers to cover defense costs or other liabilities, says attorney Stephen Rosenberg, who writes Boston ERISA and Insurance Litigation Blog. "Everything eventually makes its way through the insurance industry, in terms of any types of new lawsuits or liability theories," Rosenberg wrote. [Read More]
Study: Health Costs Higher When Hospital Compensation is Lower
When the hospital market is less competitive, spending by private insurers tends to be higher than when the hospital market is less competitive, a new study finds. The study compared geographic patterns of Medicare spending, using the Dartmouth Atlas data, with spending by big employers that cover their workers. The researchers suggest that when a small market has just one or a few big hospital systems, employers spend more than they do in large cities where there's more competition, an issue that does not generally affect government health payers like Medicare. [Read More]
AHIP: Hospital Consolidation is Driving Health Costs
When the Massachusetts Attorney General's Office released a recent report sharply critical of the state's healthcare costs, one of the office's most often used words was "driver"—referring to hidden forces steering potentially out of control expenses. Reacting to the AG's decision, health insurers' major lobby in Washington blames hospital consolidation as an often ignored reason for the soaring price of healthcare. "The data shows that [hospital consolidation] has increased healthcare costs—with a higher price for healthcare services," says Robert Zirkelbach, spokesman for the America's Health Insurance Plans. "It's something that hasn't been paid attention to. It's certainly something we're looking at." [Read More]
Managed Care Headlines
Obama Wants to Solve Childhood Obesity Problem Within a Generation
Joe Cantlupe, for HealthLeaders Media, February 9, 2010
Requests for medical data are questioned by CT doctors
Hartford Courant, February 9, 2010
States look to forestall hypothetical health insurance mandate
New York Times, February 8, 2010
Public health tab to hit milestone
Wall Street Journal, February 4, 2010
Washington state mulls public option health insurance
Puget Sound Business Journal, February 5, 2010
Number of Minnesotans uninsured jumps by 100,000
Minneapolis Star Tribune, February 8, 2010
Aetna reports profit drop, sees more declines in 2010
Wall Street Journal, February 8, 2010
Healthcare's share of U.S. economy rose at record rate
New York Times, February 4, 2010

Webcasts/Audio conferences
February 23: ED Overhaul: Reduce costs, improve quality, and increase satisfaction
March 8: Physician Compensation Models in a Strained Economy
On Demand: Joint Replacement Service Lines: Alignment and Business Strategies for a Changing Environment

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Audio Feature
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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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