HCPro Health Plan Insider - October 13, 2010 | Secrets of the Top Private Health Insurers View as a Webpage | Subscribe for Free
Secrets of the Top Private Health Insurers
Cora Nucci, Senior Online Editor for HealthLeaders Media

Behind the National Committee for Quality Assurance's annual rankings are some little-known facts about the leadership and origins of the nation's top private health insurance plans.[Read More]
cora nucci
  October 13, 2010

Editor's Picks
Comparative Effectiveness Could Save Medicare Billions, Study Says
Despite federal funding for research into how to compare various treatments, the Affordable Care Act limits the ability of the federal government to draw on comparative effectiveness research to determine what can be covered under Medicare. Politics aside, using such research to determine how much to pay for newly covered services could yield billions of dollars in savings without threatening patient choice, according to a paper in Health Affairs. [Read More]
Cutting Healthcare Costs With Care Gap Alerts
Care gap alerts, triggered by a patient's office visit and generated electronically, notify providers on the spot if a patient is due and eligible for certain medical services. The analytical benefits are clear: Payers may see the impact of care gaps by region, specialty, and cost. But a greater benefit looms: There are potential savings on services that may be avoided as a result of successful preventive screenings and procedures. [Read More]
Predictive Modeling May Reduce Hospitalizations
The Visiting Nurse Service of New York has adopted technology that appears to be effective in reducing hospitalizations and re-hospitalizations. The system identifies patients at risk for hospitalization and places them in one of seven risk categories so that appropriate clinical steps can be taken. VNSNY reports a 12% decrease in the overall patient rehospitalization rate between 2001 and 2009 and a reduction in patient episodes ending in hospitalization, from 37% to 27%, during that time. [Read More]
Intelligence Report: Physician Alignment in an Era of Change
Hospitals are looking to employ more physicians and buy more medical groups; at the same time, hospitals are receiving an increase in inquiries from physician groups for employment. But this marriage is not without trepidation. Elements of payment reform are expected to put considerable strain on hospital-physician relations. In this exclusive report based on original research and analysis, we find out what 258 healthcare executives and clinical leaders think about these topics and more. [Read More]

Register Today for Lead Transformation: Accelerate Value, Quality, and Coordination
Join us October 21, live or virtually, for this complimentary, exclusive half-day leadership event that will bring leaders from top healthcare organizations to explore real paths to take today toward accountable care structures and define what medical home and patient-centered care mean for your healthcare organization. Recognized leaders and peer experts will be featured from: Texas Health Presbyterian Hospital Dallas, Columbus Regional Hospital, Baptist Health System, Chenango Memorial Hospital, Network Health, Crystal Run Healthcare, Moffitt Cancer Center, Novant Health, and GE Healthcare, Americas. This event takes place October 21, 8:30 am—12:30 pm (CST) at The Fairmont in Dallas, Texas. To register call 800/753-0131 or click here.
Sponsored Headlines
Video: Green Data Centers to Smart Buildings with Enterprise Asset Management: Clay Nesler, of Johnson Controls, discusses how IBM asset management solutions enabled them to bring smart building solutions to the commercial and institutional marketplace. IBM Maximo, the complete end-to-end solution, addresses the instrumentation of buildings and the interconnection of that information and technical systems. Johnson Controls have been able to integrate data from all systems—reducing energy use, improving productivity and reducing costs.
Webcast: Smarter Buildings: Linking energy efficiency with facilities management and maintenance by gaining insight into facilities, their conditions and work processes, CIOs, building owners, operators and tenants are better able to plan and control their environments, thus improving overall operational effectiveness and energy efficiency.
Flash Demo: Manage Facilities with IBM Maximo Asset Management: This high-level Flash video provides an overview of how the IBM Smarter Planet campaign can help improve facilities management. By using IBM Maximo Asset Management, facilities managers are enabled to create smart buildings that reduce overall energy use and are operationally efficient.
Webcast: A Conversation with The Johns Hopkins Hospital: A conversation with Tom Lentz, Manager of IT and Finance for the Facilities Department at The Johns Hopkins Hospital in Baltimore and Axendia Industry Analyst Daniel Matlis on how The Johns Hopkins Hospital uses its Integrated Asset and Service Management solution to improve uptime to support patient care; control costs; support regulatory compliance activities; and use workflow capabilities for internal controls.

Axendia White Paper: Lowering the Cost of Healthcare from the Inside Out: This white paper, written by Axendia, discusses how integrated asset and service management enables healthcare providers to enhance patient care, improve clinical outcomes, reduce costs and ensure compliance.

Real-time asset location visibility improves operational efficiencies: This solution brief discusses how the addition of real-time asset location capabilities to IBM Maximo® Asset Management provides complete visibility of an organization's total enterprise assets in real time. This unprecedented visibility enables an organization to improve asset utilization and employee productivity by providing the current location of existing resources.
Managed Care Headlines
Health insurance mandate found to be legally sound
The Washington Post, October 11, 2010
U.S., California probe Prime Healthcare
The Los Angeles Times, October 12, 2010
WellCare expands leadership team
Tampa Bay Business Journal, October 13, 2010
CT, MRI Use in Emergency Departments Soaring
Roxanna Guilford-Blake for HealthLeaders Media, October 8, 2010
Health insurers adopt programs to cut hospitalizations, costs
The Wall Street Journal, October 8, 2010
Stay Connected to Health Plan Insider
To help us ensure future delivery of Health Plan Insider, please add our "From" address—health_plan_insider@list.hcpro.com—to your address book or e-mail whitelist.
From HealthLeaders Magazine
Your Move

The business models that will emerge in the era of healthcare reform are still unclear, but leading hospitals and health systems are already positioning themselves to adapt when they do come into focus. They're taking the first steps toward becoming accountable care organizations even before anyone knows for sure what an ACO will look like—or even if they'll ever come to fruition. [Read More]
Sponsor Health Plan Insider

Contact Paul Mattioli, Sr. Director of Sales, at pmattioli@healthleadersmedia.com or call 800.639.7477.

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.

Audio Feature
Payment Model Innovation: Sharing the Rewards of a Pay-For-Performance Program

Neal Peyser, Managing Director FTI Healthcare discusses the creation of payment incentives for better collaboration between hospitals and their medical staff. He describes how one facility was able to tap incentive payments from a commercial payer that were based on meeting quality and efficiency metrics, and share them with physicians. [Sponsored by FTI Healthcare] [Listen Now]