HealthLeaders Media Health Plan Insider - August 24, 2011 | Preview: Healthcare Benefits Changes Coming to Open Enrollment View as a Webpage | Subscribe for Free
Preview: Healthcare Benefits Changes Coming to Open Enrollment
Margaret Dick Tocknell, Senior Editor

With an eye toward cost control and new healthcare reform requirements, employers are beginning to remove annual benefit limits for preventive and wellness services. They'll also offer more incentives and consumer-directed healthcare options, modify retiree health benefits, and continue shifting costs onto employees via 'cost sharing'. [Read More]
  August 24, 2011

Editor's Picks
HHS Proposes Rules to Clarify Health Insurance Coverage
Proposed rules will require health plans to present insurance benefits and cost information in a way that will help consumers better understand their health insurance benefits and costs, and search for the most appropriate coverage. The forms, which have been likened to food labels, include a summary of benefits and coverage; and a uniform glossary explaining terms such as "deductible" and "co-pay." [Read More]
CMS Trials Bundled Payments for Episodes of Care
Following numerous demonstration projects at a number of large hospital systems, Medicare officials are proposing lump payments to providers for specific episodes of patient illness that extend well after the patient leaves an acute care setting. [Read More]
Healthcare Cost Growth Accelerates Slightly
The average per capita cost of healthcare services covered by commercial insurance and Medicare grew 5.61% over the 12 months ending in June 2011, representing a second straight month of modest acceleration of cost growth, Standard & Poor's Healthcare Economic Indices show. [Read More]
OIG: Soaring Medicaid Brand-name Drug Prices Offset by Rebates
The costs of Medicaid's brand-name drugs grew at about three times the rate of inflation from 2005-2010, but that increase was offset by rebates to state programs, according to a report from the Department of Health and Human Services Office of Inspector General. The report found that brand-name drug payments by state Medicaid programs grew between 34% and 40% for the five year period, while overall inflation grew only 13%. [Read More]
Rounds: Performance Improvement for Quality and Bottom-Line Outcomes
Date: October 26, 2011
About: Attend on-site or participate via live simulcast. Host Denver Health with invited guest Virtua share how to make continuous quality improvement with a focus on bottom-line value part of your institutional culture and process.
[Register Today]
Intelligence Report: The New Patient Experience Imperative
22% of healthcare leaders say lack of cultural fit or employee buy-in is their organization?s biggest patient experience stumbling block, according to this HealthLeaders Media Intelligence Report. Get the free report with exclusive research and analysis. [Read More]

Health Plan Forum
Norton, Humana Commercial ACO Notches Cost Savings
In a pilot, the partners have begun to track improvement along several initiatives, including a joint replacement accountability study that has seen a 7.3% reduction in direct variable cost, a 6.7% reduction in length of stay, and a 13% reduction in 30-day readmissions. [Read More]

Managed Care Headlines
CMS Accepts Parkland Hospital's Plan for Corrective Action
Margaret Dick Tocknell, for HealthLeaders Media, August 24, 2011

Parkland Hospital Submits Plan to Remedy Deficiencies, Protect Funding
Margaret Dick Tocknell, for HealthLeaders Media, August 22, 2011

Medicaid privatization firm selection challenged again
The Times-Picayune, August 24, 2011

Price List Could Be A Radical Medical Tool
WBUR, August 23, 2011

US scrambling to ease shortage of vital medicine
The New York Times, August 22, 2011

UPMC asks for dismissal of Highmark suit
Pittsburgh Post-Gazette, August 19, 2011


Sept 15: Rounds: Women's Health Strategies for Service Line Growth and Quality

Sept 16: Webcast: Slash Your Readmission Rates

Sept 22: Webcast: Quantify & Cultivate Patient Engagement

Oct 26: Rounds: Performance Improvement for Quality and Bottom-Line Outcomes


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From HealthLeaders Magazine
Nurse Education Key to Scope-of-Care Debate

There is tension between nursing leadership and some physician groups over the scope of what advanced practice nurses, including nurse practitioners, should be allowed to do. [Read More]

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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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