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Should Health Insurers Care About What's For Dinner?
Elyas Bakhtiari, for HealthLeaders Media

Although health insurers have long been aware of the burden of obesity and its connection to chronic diseases, until now they have had strategies for keeping certain high-risk patients out of their pool of customers. But because insurance companies can no longer exclude patients because of pre-existing conditions or other health indicators, preventing chronic disease is now a top business priority. Maybe it's time for insurers to get more involved in preventing obesity at the national level. [Read More]
  May 19, 2010

Editor's Picks
MA insurers blame rate increase cap for losses topping $150 million
The four major Massachusetts health insurers posted first-quarter losses totaling more than $150 million, with three of them blaming the bulk of the losses on Gov. Deval Patrick administration's decision to cap rate increases for individuals and small businesses. The carriers attributed $116 million of their $152 million in losses to the April 1 ruling by the state Division of Insurance to deny most proposed premium increases for the so-called small-group market. The poor quarter may be a warning for other insurers, as the U.S. Senate is considering similar rate caps for insurers nationwide (see below). [Read More]
Federal Law Proposed To Regulate Health Plan Premium Hikes
U.S. Sen. Dianne Feinstein (D-CA) and Rep. Jan Schakowsky (D-IL) again called for passage of companion bills they've introduced to mandate federal oversight of health plan premiums, saying it's clear now that insurance companies are more concerned about profits than patients. Schakowsky singled out WellPoint in California, calling it "the poster child for unbridled greed," because of its attempt earlier this year to raise premiums 39% for the commercial market. The companion bills the lawmakers have introduced would require health plans to submit rate hikes over a certain amount to the Secretary of Health and Human Services for review and approval. [Read More]
Provider Groups, Insurers Weigh in on Defining Medical Loss Ratios
A battle over regulatory interpretation is brewing over the issue of medical loss ratio—a provision included in the new healthcare reform act that will require health insurers to spend at least 80 cents out of every premium dollar in the individual and small group markets on actual medical care and at least 85 cents in the large group market on that care starting Jan. 1, 2011. The medical loss ratio should not be used as a vehicle to "remove quality programs and their benefits from policyholders" and should reflect "what health plans are doing to improve quality through patient and clinical services and health information technology," said America's Health Insurance Plans. [Read More]
Workplace set to remain key source of health coverage
The share of Americans who get health coverage through their jobs has been declining gradually for years, dropping to 63.3% of working-age adults in 2008. The question now is whether the new health law will induce more employers and workers to turn to government coverage options. In the near term, at least for the total figures, that is unlikely, the Wall Street Journal reports. For the next decade, the overall number of Americans with workplace health benefits isn't likely to change much, government analysts suggest. [Read More]
Managed Care Headlines
WellPoint CEO is grilled
Wall Street Journal, May 19, 2010
Insurers, commissioners hammer out details of healthcare reform
Washington Post, May 17, 2010
Health overhaul hits sales commissions
Wall Street Journal, May 18, 2010
Washington, DC, jumps at healthcare savings in expanded Medicaid
Washington Post, May 14, 2010

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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]
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
EHR and Market Growth

In a world of skyrocketing health costs and dwindling employer-based insurance members, the individual market is one of the few areas of growth opportunity for health insurers. And while the market is rife with politics and uncertainties, experts say insurers have an opportunity with individual markets to largely expand their programs. [Read More]
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