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Getting Personal About Diabetes
Les Masterson, Senior Editor-Managed Care

UnitedHealth Group has launched two diabetes programs with help from YMCA of the USA and Walgreens that the companies hope will prevent and control diabetes, pre-diabetes, and obesity. These are the kinds of innovations health insurers and employers will need to try in order to remove cost barriers and lower long-range health costs. That's beneficial on a systemwide level, but let's also remember the personal reasons for these kinds of programs—they may help diabetics and prediabetics live longer lives and cause fewer young men to lose their fathers too soon. [Read More]
  April 21, 2010

Editor's Picks
Insurers Agree to Cover Young Adults Under Parents' Plans
Three more health insurers agreed to provide health insurance coverage for young adults under the age of 26 under their parents' plans. Health reform will require insurers to offer that coverage on Sept. 23, but the insurers have agreed to start earlier as many young adults graduate from college and face months of not having insurance until they find a job that offers health coverage. This is a wise move by insurers. Young adults don't use many healthcare services so they won't see many costs from their decision, and it's positive PR for an industry that has often been vilified this year. [Read More]
CIGNA, Humana team up to sell Medicare Advantage
Medicare Advantage has been under fire over the past couple years and some have wondered whether the feds cutting payments to private insurers will ultimately kill the program over the next few years. However, two insurers are not retreating. CIGNA and Humana, the second largest Medicare Advantage insurer, announced they will work together to offer Medicare Advantage plans to employers that provide retiree health coverage. The agreement will allow CIGNA to sell Humana's Medicare Advantage plans to CIGNA's employer-based customers. While CIGNA will manage the accounts, members will have access to Humana's network of doctors and hospitals. [Read More]
Senate bill sets a plan to regulate premiums
Hoping to close a loophole in health reform, Senate Democrats proposed legislation that would allow the secretary of health and human services to review insurance premiums and block those that are "unreasonable." Many states already have this in place. This legislation would cover states whose officials don't have "sufficient authority and capability." A similar proposal was in an earlier version of health reform, but was removed before the final vote. Health insurance industry critics are concerned that health insurers may jack up rates for sick members before 2014, which is when insurers won't be allowed to charge higher premiums to its sickest members. [Read More]
Seven Health, Political Leaders Respond to Berwick's Nomination to Lead CMS
The worst kept secret in healthcare is officially out in the open. President Obama nominated Donald Berwick, MD, as the Centers for Medicare and Medicaid Services administrator. Berwick, president and CEO of the Institute for Healthcare Improvement and a professor at Harvard Medical School and the Harvard School of Public Health, has been an outspoken advocate for improving healthcare quality, value, cost, and safety. The CMS administrator position has historically been more of a bureaucrat so it will be interesting to see how Berwick takes to the new position. Before he takes the reins, however, he will have to go through confirmation hearings on Capitol Hill. Republicans have said they will delay Obama nominees that would implement health reform programs. Let's hope this process can get over quickly so CMS can finally have a leader after four years. [Read More]
Looking for Strong Leadership Teams
The deadline is approaching to enter the seventh annual Top Leadership Teams in Healthcare Awards—a program that celebrates stories of great healthcare leadership in hospitals, health plans, and medical group practices. There are five categories: large hospitals and health systems (500 or more licensed beds); community and mid-sized hospitals (100 to 499 licensed beds); small hospitals (fewer than 100 licensed beds); health plans (state, regional, and national); and medical group practices (physician-owned, single- or multi-specialty groups employing 25 or more physicians). Previous winners in the health plan category include Independent Health in Williamsville, NY, and Harvard Pilgrim in Boston. [Learn More]
Managed Care Headlines
Large Patient Information Breaches Skyrocket
Dom Nicastro, for HealthLeaders Media, April 16, 2010
Massachusetts Connector chief to step down
Boston Globe, April 16, 2010
Massachusetts wants court to enforce health rates order
Boston Globe, April 19, 2010
Health insurers weighing options to get ahead of reform
Washington Post, April 19, 2010
Hospitals are opting out of new Minnesota health plan
Minneapolis Star Tribune, April 19, 2010
UnitedHealth CEO Stephen Hemsley was paid $102 million in '09
Minneapolis Star Tribune, April 15, 2010

Webcasts/Audio conferences
April 22: Neuroscience Service Lines Strategies
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May 19: Five Proven Steps to Improve Patient Satisfaction Scores
June 2: Seamless Systems of Care: Better Alignment, Coordination, and Outcomes

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Audio Feature
The State of HSAs

Martin Trussell, senior vice president of business development at First Horizon Msaver, a leading provider of health savings accounts, talks about the state of HSAs and how health reform will affect them. [Sponsored by Emdeon] [Listen Now]
Audio Feature
Strategies for Reducing Drug Spending

Find out how Virginia Commonwealth University Health System saved $2.5 million annually from their outpatient drug spending by working with a nonprofit group to qualify more patients for their appropriate prescription benefits and reducing their drug purchase costs through bulk purchasing. [Sponsored by Emdeon] [Listen Now]
Health Plan Forum
Senate Panel: Insurers Spending Too Much on Overhead

Health insurers' medical loss ratios in many markets are still falling far below the minimum levels of what they will need to spend under health reform signed into law last month by President Obama. These new medical-loss ratio floors go into effect on Jan. 1, 2011, according to a new report released by the chairman of the Senate Commerce, Science, and Transportation Committee. [Read Now]
From HealthLeaders Magazine
Putting the Consumer in Charge

The relationship between insurers and their members has been traditionally cool—at best. On the positive side, consumers see health insurers as the faceless entity that pays for their care and, more negatively, the companies that reject paying for care. The consumerism movement in benefit design has shifted more costs and decision-making to individuals. By 2020, members will have even greater responsibility for their healthcare. Members will need to become better healthcare consumers. Health insurers see the transformation coming, and leaders are preparing. [Read More]
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