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  December 19, 2012 Follow us on FacebookFollow us on TwitterJoin us on LinkedInRSS feed

Payers' Role in Exchanges Unclear

Jacqueline Fellows

We have a good idea of how states will approach health insurance exchanges, but in which states will health plans participate? Commercial payers already in the group and individual markets appear to be in the best position to take part. >>>


Editor's Picks

How $7.7B Baylor, Scott & White Deal Might Affect Healthcare Costs

While the proposed merger improves the unified system's economies of scale, efficiencies, market share, and negotiating clout with payers, there are questions about whether or not the accelerating trend of hospital consolidations such as this are escalating healthcare costs for consumers. >>>

CFOs' Top 3 Lessons of 2012

A year's worth of research, interviews, and discussions with chief financial officers of hospitals and health systems yields lessons about the impact of healthcare reform on physician payments, sustainable cuts, and new paths toward growth. >>>

States Lean on Feds for Health Insurance Exchanges

As of the deadline Friday, 25 states have decided to let the federal government set up and run their exchanges and 18 states and the District of Columbia have said they will run their own. >>>

Medicare, Hospitals at Odds Over Payment for Sicker Patients

While hospitals are managing Medicare patients with rising rates of chronic disease, the federal government "doesn't want to pay more for the rising severity that has been uncovered by their new, more accurate payment system," says an analyst with the American Hospital Association. >>>

Big Data Sparks a Quest for Simplicity

The end of the year is a great time to pause and ask ourselves whether we are trying to gather too much data too fast. Maybe what we really need is small data—the data that matters most. >>>

IHI: Time to Get Serious About Healthcare Quality, Costs

Keynote speakers at the Institute for Healthcare Improvement's national conference urged healthcare leaders to crack the code on raising healthcare quality and reducing costs. Don Berwick, MD, did not mince words about where he thinks many of the improvements should come from. >>>

Intelligence Report

Regulatory Strategies—From Medicare to Meaningful Use

More than one in three U.S. healthcare executives acknowledge they are "not prepared at all" to make the leap from fee-based payments to shared-risk payments. This free report offers insight from top healthcare executives on the necessary shift toward the shared-risk reimbursement models that are central to the implementation of the Patient Protection and Affordable Care Act.

Download your free report today

News Headlines

Aetna CEO Bertolini: Get ready for 'rate shock'

Forbes, December 19, 2012

Hospital systems to form their own insurance company

The Atlanta Journal-Constitution, December 19, 2012

MD health reform council adjusts insurance plan model

Baltimore Business Journal, December 19, 2012

Obamacare: 'It's a massive, nine-month sprint'

The Washington Post, December 18, 2012

CA health plan may have overbilled Medicare $424M

California Watch, December 18, 2012

As docs flock to hospitals, bills spike for patients

The Charlotte Observer, December 17, 2012

Health insurers' market is jumbled

Star Tribune / Bloomberg News, December 17, 2012

Healthcare reform exclusions raise concerns over funding for uninsured

Las Vegas Sun, December 17, 2012

A shift in how healthcare is paid for

Los Angeles Times, December 14, 2012

Only 15 states to operate own health exchanges

Insurance Journal / Reuters, December 14, 2012

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Webcast: Optimize the Nurse Skill Set—Lower Labor Costs and Raise Quality

Date: January 24, 2013, 1:00-2:30 p.m. ET

As the Centers for Medicare & Medicaid Services develops new programs and tools as a result of the Patient Protection and Affordable Care Act, healthcare providers must focus on the care continuum model. Join Glide Health Services and Huron Healthcare as they share their tools for managing nurse labor costs.

Register Today

From HealthLeaders Magazine


20 People Who Make Healthcare Better—2012

They are nurses and physicians. They are researchers and executives. They are providers and payers. They are watchdogs and innovators. And they are patients. They are this year's HealthLeaders 20 honorees, selected for their efforts to make healthcare better. >>>


Anesthesia and Operating Room Efficiency


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