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DOL Report Flunks a Major Test
Margaret Dick Tocknell, Senior Editor

Last month the Department of Labor released a report in that under-the-radar way that makes you immediately wonder what's up. For a report that's supposed to help guide decisions about what constitutes essential healthcare benefits, it's very light on what is actually covered. [Read More]
  May 4, 2011

Editor's Picks
Health Plan, Provider Partnerships May Trump ACOs
With more than four million Medicare fee-for-service beneficiaries expected to receive medical care through accountable care organizations beginning in 2012, hospitals and physicians are aligning to provide the coordinated care that could eventually entitle them to federal financial incentives. A briefing paper from the actuarial and consulting firm Milliman, however, suggests that becoming an integrated delivery system, partnering with a health plan, and focusing on the Medicare Advantage market may make more sense. [Read More]
ACOs in health reform decoded
Fragmentation and unnecessary testing are two of the hallmarks of medical care in the United States. They're also a major factor in what's driving the cost of healthcare through the roof. The Kaiser Family Foundation has just released its annual report on healthcare spending in the United States and found that $7,538 a year is now spent on each American. [Read More]
Large Patient Information Breach List Climbs to 265
The number of entities reporting breaches of unsecured PHI affecting at least 500 individuals to the Office for Civil Rights, the enforcer of the HIPAA privacy and security rules, has reached 265. Health insurance giant Health Net, Inc. earned the spot as the largest on the list with a potential breach affecting 1.9 million health records. [Read More]
Impact Analysis: Leaders Respond to CMS' Proposed ACO Regulations
The proposed regulations are indeed out, but what do they really mean to your organization and the industry? Get reactions from leaders at hospitals, health plans, and physician practices that are already well-versed in accountable care organizations, including Monarch Healthcare, Alegent Health, Kaiser Foundation Health Plan /Kaiser Foundation Hospitals, Geisinger Health System, Dean Health System, and Scripps Health. [Read More]
Webcast: Achieving Ambulatory Surgery Center Success in the Reform Era
Reform, reimbursement, and reintegration—a triple threat to ambulatory surgery centers (ASCs) or new opportunities for ROI? Join HealthLeaders Media on May 11 for a 90-minute Webcast, including Q&A, to learn how to increase the financial return of ASC operations from leaders with proven ambulatory care ROI. [Read More]
Webcast: Ratchet Up Physician Referrals: Proven Methods & Measures
At the heart of successful physician referral programs are relationships that result in buy-in, engagement, and alignment. How do you build those? And, how do you use data to prove your program's success to the C-suite? Join HealthLeaders Media on May 18 for this 90-minute Webcast, including Q&A and case studies, for lessons and insights from marketing leaders with successful referral programs. [Read More]

Health Plan Forum
13 Hot ACO Buzzwords
Just in time to accompany the proposed accountable care organization guidelines from the Centers for Medicare & Medicaid Services, comes a handy glossary of federal healthcare policy lingo. [Read More]

Managed Care Headlines
MD docs push for control of patients' access to care
The Baltimore Sun, May 3, 2011

MA insurers' ambulance bill practice protested
The Boston Globe, May 4, 2011

SC BlueCross: Rising premiums and pay
The State, May 3, 2011

Hospital Labor Costs Inch Up in Q1
HealthLeaders Media, May 3, 2011

ACO rules limit patient telehealth options
InformationWeek, May 2, 2011

Low Health Literacy Linked to Mortality in CHF Patients
HealthLeaders Media, April 28, 2011


May 11: Webcast: Achieving Ambulatory Surgery Center Success in the Reform Era

May 18: Rounds: Neurological Service Line Growth: Telestroke & Brain Tumor Innovations

May 18: Webcast: Ratchet Up Physician Referrals: Proven Methods & Measures

May 24: Webcast: Blueprint for an Integrated and Alignment-Driven Physician Compensation Plan


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From HealthLeaders Magazine
In an ACO, Who's Accountable?

It can be the hospital, but health plans, physician practices and medical service organizations can also serve as the "accountable" party. [Read More]

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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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