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5 HIX Challenges for Health Insurers
Margaret Dick Tocknell, Senior Editor

Much of the focus on health insurance exchanges has been on what states will need to do to create and manage them, but health plans need to get in the game and start planning how they will position themselves to sell their products in what is estimated to be a $60 billion business. [Read More]
  July 13, 2011

Editor's Picks
HHS Releases Proposed Rules for HIX
The creation of health insurance exchanges took another step forward with the release of the long awaited proposed rules that outline the requirements a state must meet to launch an exchange. The exchanges, which were created by the Affordable Care Act, are expected to provide coverage to an estimated 11.5 million people, including members of Congress, in 2014. [Read More]
UnitedHealth Group False Claims Suit Back on Track
A ruling by the Third Circuit Court of Appeals in Philadelphia will allow a portion of a kickback case against UnitedHealth Group Inc. and its subsidiary, AmeriChoice New Jersey, to proceed. The whistleblower suit involves charges by two former employees that UHG and AmeriChoice provided kickbacks to a New Jersey medical clinic. [Read More]
Winners and Losers Under VBP
In the pursuit of quality, it would be nice to think that everyone is a winner. But that?s not the case with CMS? value-based purchasing program. It?s set up to separate the winners from the losers. To succeed under the Centers for Medicare & Medicaid Services' value-based purchasing plan, CFOs must collaborate with clinical leaders and monitor efforts closely. [Read More]
15 HCAHPS Buzzwords Every Provider Should Know
The value-based purchasing sweepstakes race is on. It's hospital against hospital in a national contest to see which acute care teams can please their patients the most on the Hospital Consumer Assessment of Healthcare Providers and Systems survey. Knowing the lingo is key. [Read More]
Webcast: Cultivating Physician-Hospital Alignment in the ACO Era
Date: July 20, 2011
About: Integration will be the key to success in the accountable care era, whether your organization develops an official ACO or not. Organizations must develop strong relationships with employed and affiliated physicians. Join us to get alignment strategies to thrive in an increasingly integrated industry.
[Read More]
Rounds: The Real Value of ACOs
Date: August 16, 2011
What: Attend on-site or participate via live webcast.
About: Get accountable care strategies from ACO pioneers Norton Healthcare, Humana, and Palmetto Health--first movers who already have experienced the challenges of building a new framework for healthcare delivery.
[Read More]

Health Plan Forum
ACO or Not, Fairview Builds Shared Savings into All Payer Contracts
Minneapolis-based Fairview Health Services has taken a model for shared savings and quality improvements and gradually embedded the concepts into all of its commercial insurance contracts. [Read More]

Managed Care Headlines
Inadvertent experiment measures impact of health coverage
The Oregonian, July 7, 2011

CMS to Conduct Insurance Rate Reviews for 10 States Beginning Sept. 1
Healthcare Finance News, July 11, 2011

Revascularization of AMI Patients Persists Despite No Demonstrated Benefit
Cheryl Clark, for HealthLeaders Media, July 13, 2011

MA Blue Cross to Refund CEO?s Exit Pay to Clients
The Boston Globe, July 7, 2011

AHA Details Hospitals' $2.2T Economic Activity
John Commins, for HealthLeaders Media, July 7, 2011

Fake Doctor Admits Real Medicare Scam
John Commins, for HealthLeaders Media, July 13, 2011

Opinion: Sunlight really works!
The Boston Globe, July 12, 2011


July 20: Webcast: Cultivating Physician-Hospital Alignment in the ACO Era

July 27: Webcast: Creating an ACO Marketing Language

August 16: Rounds: The Real Value of ACOs


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Audio Feature
ACO Appeal for Hospitals Needs a Boost

Stephen L. Mansfield, PhD., president and CEO of Methodist Health System in Dallas discusses what needs to happen to get hospitals excited about ACOs and what it will take to make ACOs sustainable. [Sponsored by Emdeon] [Listen Now]
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