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Five Changes Health Plans Need to Make Now
Les Masterson, for HealthLeaders Media

Over the past three issues of HealthLeaders magazine, I wrote a three-part series looking at the health plan of 2020. I examined possible payment models, benefit designs, and member relationships in 10 years. I started writing the series when health reform looked iffy at best, but with or without health reform, insurers need to prepare for a very different world by 2020. Here are five changes health insurers need to make now in order to survive in 10 years. [Read More]
  May 12, 2010

Editor's Picks
Interim Rule Issued on Young Adult Health Insurance Coverage
Young adults up through age 26 who continue to stay on their parents' health insurance plans under the new healthcare reform provisions cannot be required by health insurers to pay more for their coverage than those family members currently covered, according to a new interim final rule released Monday by the Department of Health and Human Services. Annual premium costs for adding a young adult—using a mid range estimate—would be $3,380 in 2011, $3,500 in 2012, and $3,690 in 2013, according to HHS. [Read More]
WellPoint rates face new scrutiny from state and federal officials
Remember that massive premium rate hike that a WellPoint subsidiary proposed toward the end of the healthcare reform debate? The one that gave reformers new momentum for a final push? It turns out that the company may have used inaccurate or faulty information to justify increases, which WellPoint says was "inadvertant." U.S. Sen. Dianne Feinstein (D-CA) called for congressional hearings into the errors. The Obama administration, meanwhile, has urged other states to reexamine rate hikes proposed by WellPoint amid the uproar. [Read More]
Missouri voters may be voting on the new federal health insurance mandate
The Missouri House gave final approval to a measure that will appear on the Aug. 3 ballot stating that people and employers cannot be compelled to have health insurance nor penalized for paying for healthcare on their own. The referendum seeks to defy a federal healthcare law signed earlier this year by President Barack Obama. [Read More]
Managed Care Headlines
Healthcare overhaul is up against long campaign across U.S.
Washington Post, May 12, 2010
Aetna may cut NC-based Novant Health from its network
Charlotte Observer, May 12, 2010
Minnesota nurses, doctors, hospitals urge shift to Medicaid
Minneapolis Star Tribune, May 11, 2010
Fight erupts over rules issued for mental health parity insurance law
New York Times, May 10, 2010

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Webcasts/Audio conferences
May 13: Integrated Compensation Plans to Enhance Physician Performance
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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
More Efforts Called for Defining Medical Loss Ratio by Locality

Some health insurers are "mounting an all-out effort to weaken" the new healthcare reform provision that establishes minimum medical loss ratios in the commercial health insurance market, according to Sen. Jay Rockefeller (D-WV), chairman of the Senate Commerce, Science, and Transportation Committee. Information obtained by the committee shows that medical loss ratios "significantly vary according to where consumers live and in which market segment they are shopping for health insurance," Rockefeller said. [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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Resources From HCPro

Learn how increased collaboration between providers and managed care payers has the potential to reduce costs, improve processes, and enhance patient care.
Discover how to integrate wellness into your DM programs.
Read about practical strategies for maximizing the effectiveness of health and disease management programs.
Learn how to educate and engage members.
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