HealthLeaders Media Health Plan Insider - March 23, 2011 | MLR May Sting, but HIEs Could KO Health Insurance Brokers View as a Webpage | Subscribe for Free
MLR May Sting, but HIEs Could KO Health Insurance Brokers
Jeff Elliott, for HealthLeaders Media

A battle to exempt health plan broker commissions from the medical loss ratio rule is underway. But a more serious threat may be lurking in the form of the health insurance exchanges that could effectively eliminate the need for agents and brokers.[Read More]
  March 23, 2011

Editor's Picks
AFib Costs, Medicare Impact Detailed
Despite the high costs and heavy demand for atrial fibrillation services, states aren't providing residents with the resources to address and manage the chronic disease, research suggests. [Read More]
Medicaid Enrollment to Outpace Primary Care Providers
States with the smallest number of primary care physicians per capita overall—generally in the South and Mountain West?potentially will see the largest percentage increases in Medicaid enrollment, study shows. [Read More]
Bundled Payments for Oncology
In a nod toward ACOs, UnitedHealthcare is testing a payment model designed to advance better medical outcomes in the treatment of certain cancers. One of the tenets of the fledgling accountable care organization is the concept of bundled payments, which replaces the current fee-for-service model of provider reimbursements. [Read More]
Webcast: Boost Market Share with Your Oncology Services
Given the growing trend toward all-inclusive cancer centers, do you know how to differentiate your own oncology services to protect and grow your market share? Your oncology care is distinct. Its marketing should be, too. Join HealthLeaders Media on March 31 for this 90-minute Webcast, including Q&A and a case study, for valuable lessons from marketing leaders. [Read More]
Rounds: Orthopedic Leadership Strategies: Engage, Measure, and Perform
Forward-thinking orthopedic leaders are ensuring high performance and coordination among a carefully constructed caregiver team. Those leaders are also exploring the right metrics to know whether the outcomes they are tracking are the most meaningful to patients. Join the executive and clinical leadership team from nationally renowned MemorialCare Health System and orthopedic innovator Marshall Steele, MD, on March 239 for a three-hour dive into essential orthopedic leadership strategy. [Read More]
Healthcare Leaders Reveal Uncertainties About Industry Direction
Dedication to mission is strong and getting stronger, but just how to accomplish that mission is less certain, according to the just-released results of the 2011 HealthLeaders Media Industry Survey. [Read More]

Health Plan Forum
10 Healthcare Reform Market Changes Affecting Physicians
While specific regulations from the Patient Protection and Affordable Care Act are still evolving, marketplace trends and healthcare reform have clear implications for physicians regarding private payer initiatives, physician-hospital integration, and government action. [Read More]

Managed Care Headlines
Adding up health reform after the first year
PBS NewsHour, March 23, 2011

Getting HIT ready for ACOs
HealthData Management, March 23, 2011

RI's Landmark Medical Center sues Blue Cross over payments
Providence Journal, March 23, 2011

CA's Anthem Blue Cross reduces rate increases
Los Angeles Times, March 22, 2011

A panel decides Washington State's healthcare costs
The New York Times, March 22, 2011

States rush to settle Medicaid bills
USA Today, March 22, 2011

MA insurer battles identity crisis
The Boston Globe, March 21, 2011

Sponsored Headlines
Case Study: Mayo Clinic helps radiologists pinpoint potential problems : Mayo Clinic transforms the way it processes and interprets medical imaging results to enable more accurate detection. Powerful algorithms pinpoint potential problem areas within medical images and flag them based on the probability of abnormality. This process transformation increases diagnostic sensitivity for detection of brain aneurysms through intelligent flagging of high-risk areas.

Case Study: University College London Hospitals: UCLH had to adhere to the 18wkRTT requirements stated by the U.K. government. The BPM based Patient Tracking System (PTS) enabled them to better manage their clinical pathways and resources and also help improve patient experience by reducing uncertainty in the scheduling of treatments.

Discover, Interact, and Optimize for Smarter Healthcare with BPM Powered by Smart SOA: This IBM® RedguideTM describes one of the most significant challenges in healthcare today: the need for healthcare providers to effect patient care positively and proactively in the face of increasing patient load and information overload. IBM WebSphere® business process management (BPM) powered by smart service-oriented architecture (SOA), or BPM powered by Smart SOA, has the potential to maintain the medical common body of knowledge. It also makes critical, current data available to practitioners in a manner that is consistent with the evidence-based, event-driven environment to which healthcare aspires. BPM powered by Smart SOA can also automate healthcare provider administrative and care delivery processes.


March 29: Rounds: Orthopedic Leadership Strategies: Engage, Measure, and Perform

March 31: Boost Market Share with Your Oncology Services

On demand: Cardiac Care Leadership for Improved Alignment and Outcomes

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From HealthLeaders Magazine
Reform Sharpens Focus on Quality Outcomes

The ability to achieve and demonstrate quality outcomes is becoming increasingly important. [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.
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Audio Feature
Will DOJ Quash Insurers' Most Favored Nation Clauses?

A recent Department of Justice lawsuit threatens the "most favored nation" clauses common to many insurer contracts with healthcare providers. Attorney Dale Grimes of Bass, Berry & Sims discusses the potential upheaval associated with this contracting mainstay. [Sponsored by Emdeon] [Listen Now]
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