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2009 | 2008 | 2007 | 2006

Population Health Insider

Issue 10, October 1, 2009 - VIEW THE FULL ISSUE | A PDF OF THE FULL ISSUE

• California pushes to enact strongest anti-rescission law in the nation

  A bill that may become the strongest legislation in the nation to prevent health plans from...

• AHIP study: Medicare Advantage provides better care than FFS Medicare

  The health insurance industry’s lobbying group says new government data support its claim...

• Four ways to get more young adults health coverage

  Health insurers know the importance of signing up so-called “young invincibles” to...

• New efforts to insure young adults may beat reform

  One of the largest groups of uninsured in the country today is young adults—those aged...

• Nine health leaders respond to Obama’s reform speech

  In an attempt to guide the healthcare debate that has veered off the tracks in recent weeks...

• Group charges health insurers are violating state labor code

  A California-based consumer group is asking the state’s attorney general, Jerry Brown, to...

Issue 9, September 1, 2009 - VIEW THE FULL ISSUE | A PDF OF THE FULL ISSUE

• Tailoring DM interventions could improve patient outcomes, lower utilization

  One size does not fit all in almost every aspect of life, so why should healthcare think...

• Prevention and health promotion could save Medicare $1.4 trillion over 10 years

  Government health promotion and prevention programs for pre-Medicare and Medicare populations could...

• BCBSA study shows low health plan administrative costs

  Private health plans’ administrative costs averaged 9% of premiums across all policies sold...

• BCBSA companies took loss in 2008

  Blue Cross Blue Shield Association (BCBSA) companies posted an aggregate 40.9% year-over-year...

• Insurers’ rating outlooks tumble

  Health insurers are concerned that healthcare reform could damage their companies, but the mere...

• Small businesses could win big in House health reform bill

  Small businesses—particularly those with 10 employees or fewer—stand to be the big...

• Eight tips to help get your business associates to comply with HIPAA

  Your business associates (BA) must comply with the HIPAA security rule beginning February 18, 2010.

• BAs, covered entities should comply with HITECH now

  Business associates (BA) and covered entities want to know what they must do to comply with the new...

• BCBSA puts bank up for sale

  The Blue Cross and Blue Shield Association’s (BCBSA) attempt at a healthcare bank appears to...

• Could a Massachusetts-style individual mandate work across the nation?

  Can the federal government apply an individual mandate, such as the one in Massachusetts, across...

• ICD-10 implementation: Critical steps insurers must take

  With a public insurance option hanging over their heads and a sputtering employer-based market...

• Hospitals would see 32% payment drop with public plan

  The public health insurance plan proposed under the House healthcare reform bill (HR 3200) would...

• AHIP decries ‘exorbitant’ out-of-network charges

  The health insurance industry’s trade group wants state and federal policymakers to examine...

• Health insurers, employers could play key roles in tackling healthcare disparities

  There are two stakeholders who hold enormous potential in reducing or eliminating racial and ethnic...

• Health cooperatives can’t replace public option

  Consumer health cooperatives “are not yet ready for prime time” and “are...

• Marketing and technology may soon play bigger roles in health insurance

  Health insurers that are anxiously waiting for healthcare reform to shake out before moving forward...

• HHS fires up rhetoric against health insurance industry

  The Obama administration’s pugnacity toward the nation’s private health plans...

• Health card companies defrauding patients shut down

  Lisa Truong’s $28,000 bill from a San Francisco hospital is just one reason the California...

Issue 8, August 1, 2009 - VIEW THE FULL ISSUE | A PDF OF THE FULL ISSUE

• Consumers interested in technology, but not using it now

  Health insurers have spent millions on improving member outreach on the Web, but most people still...

• Five key questions about an insurance exchange

  Imagine a Web site that allows consumers to compare health insurance plans and select one that best...

• Insurers: Added regulations through health reform will increase plan costs

  For those who see private health insurance as a major problem in the healthcare system, reform is a...

• Health reform calls for preventive care, but questions persist about savings

  Supporters say prevention will save the nation billions in averted long-term healthcare costs, and...

• Healthy San Francisco has increased access

  Healthy San Francisco, held up as a model employer “pay or play” strategy, is two...

• Pharma agrees to fund part of Medicare doughnut hole

  The Pharmaceutical Research and Manufacturers of America, following negotiations with lawmakers...

• Many business associates not ready to comply with HIPAA

  Since the Health Information Technology for Economic and Clinical Health (HITECH) Act passed...

• Cost of hospital care for obese children has doubled

  Americans, and specifically taxpayers, paid nearly double in costs of hospitalizing obese children...

• Physician compensation trails inflation

  Physicians’ overall compensation in primary and specialty care did not keep pace with...

• ‘Rip-off’ insurance scam shut down

  A nationally widespread insurance scam has been shut down in California after hundreds of victims...

• Blue Cross Blue Shield of Massachusetts rewards docs for efficient quality of care

  Many primary care physicians practicing under contract with Blue Cross Blue Shield of Massachusetts...

Issue 7, July 1, 2009 - VIEW THE FULL ISSUE | A PDF OF THE FULL ISSUE

• Public insurance is not the only issue for insurers

  Private health insurance faces a potential new competitor—the federal government—that...

• Medical cost trend fairly stagnant, but consumers shouldering bigger load of healthcare costs

  The total 2009 medical cost for a typical American family of four in an employer-sponsored PPO will...

• Insurers are paying faster and denying fewer claims

  Health insurers are paying physicians 5% faster and denying 9% fewer medical claims than last year...

• Payers’ administrative practices costing physician offices as much as $31 billion annually

  Physicians spend three hours per week?43 minutes on average per workday?haggling over claims...

• Report: States could save money by expanding Medicaid managed care

  Medicaid managed care is providing a safety net of care coordination to millions of at-risk...

• Bill would test value-based insurance in Medicare

  Recently filed legislation would create a demonstration project to test whether value-based...

• Businesses with comprehensive health management programs enjoy better engagement, health outcomes

  Employers that utilize best practices tend to perform better than their peers, but how do you...

• PBM sale highlights dilemma for health plans

  In a move that will rocket Express Scripts to the upper reaches of the pharmacy benefit management...

Issue 6, June 1, 2009 - VIEW THE FULL ISSUE | A PDF OF THE FULL ISSUE

• DTCC saves money, improves clinical measures and prevention

  Pharmacists have taken on a greater presence on the healthcare team in programs such as the...

• Alternative to HRAs: Using microsegmentation to reach at-risk patients

  Tobacco and food companies find potential customers by using demographic and consumer attitude...

• Health plans need to prepare for climate change threats

  A new regulation will require health insurers to think about climate change and how it could affect...

• Aetna study: CDHP patients do not put off preventive care

  Whenever there is talk about consumer-directed health plans (CDHP), the recurring questions revolve...

• PBM sale highlights dilemma for health plans

  In a move that will rocket Express Scripts to the upper reaches of the pharmacy benefit management...

• Reports show benefits, problems with public option

  A leading proponent of creating a public insurance option recently released a 27-page report that...

Issue 5, May 1, 2009 - VIEW THE FULL ISSUE | A PDF OF THE FULL ISSUE

• Stimulus law makes changes to HIPAA

  The $787 billion American Recovery and Reinvestment Act of 2009 pushes healthcare into a new era of...

• Employers concerned about future of health benefits

  Healthcare costs are expected to stay steady for the third straight year in 2009, but that news is...

• Member experience has direct correlation to plan satisfaction

  Health plan members list coverage, benefits, and provider choice as the top factors in whether they...

• Three types of alignment for better payer-provider relations

  : HCPro recently published The New Era of Healthcare: Practical Strategies for Providers and...

Issue 4, April 17, 2009 - VIEW THE FULL ISSUE | A PDF OF THE FULL ISSUE

• Study shows difficulties in coordinating care

  Saving money and reducing hospitalizations in the chronic care population is difficult, but more...

• Health plans, physicians disagree on healthcare

  Health plan executives believe quality improvement initiatives, pay for performance (P4P...

• VBID may have a place in healthcare reform

  Policymakers looking for ways to cut healthcare costs and improve patient outcomes may have a...

• Quality, positive ROI not mutually exclusive

  Evidence-based interventions that improve quality are more likely to bring positive return on...

• What's important to hospitals, employers differ

  How much health insurers pay is important to hospital executives, but it pales in comparison to...

Issue 3, March 1, 2009 - VIEW THE FULL ISSUE | A PDF OF THE FULL ISSUE

• Employers raising PPO deductibles to offset costs

  The line between PPOs and consumer-driven health plans (CDHP) has become increasingly blurred as...

• CIGNA trumpets lower costs, better prevention in CDHP

  Members in the organization’s CDHP, called CIGNA Choice Fund, cost less than those in PPOs...

• Good health = good business

  Whether a business succeeds or fails could depend as much on a company’s wellness culture and...

• Patient alerts improve compliance

  ActiveHealth Management, a New York City–based health management services company that offers...

• Poor risk contract results not common

  Skeptical physician groups often say poor risk contract financial performance is the reason they...

Issue 2, February 1, 2009 - VIEW THE FULL ISSUE | A PDF OF THE FULL ISSUE

• CMS: MHS did not save money or improve health

  The second interim report of the Medicare Health Support (MHS) project was not what disease...

• Health Dialog implements what it learned from MHS

  As one of the leaders in disease management (DM), Boston-based Health Dialog knows how to reach and...

• Chronic illness self-management puts patient in charge

  The one who controls an individual’s healthcare is not the doctor, the health plan, or...

• Technology lends a hand

  The year 2008 was a tough one for disease management (DM). The Centers for Medicare & Medicaid...

• Grassroots programs tackle healthcare problems

  A BlueCross BlueShield Association (BCBSA) program is using a bottom-up approach in hopes that a...

• MGMA confirms costs outpace revenues

  A recent report from MGMA confirms that operating costs are rising faster than revenue in many...

• Low reimbursement depresses compensation

  With their reimbursement rates often driven by Medicaid, pediatricians are among the lowest paid of...

Issue 1, January 1, 2009 - VIEW THE FULL ISSUE | A PDF OF THE FULL ISSUE

• Workplace wellness stretches across globe

  Businesses devise programs for myriad reasons Unlike U.S. companies, which implement wellness...

• Consumer-driven plans creating cost-conscious consumers

  But many CDHP members are unaware of price, quality information Consumer-directed health plan...

• More than one in five U.S. adults at lower activation levels

  Those who are activated in their health are more apt to stay current on their medications, more...

• High demand, increased procedures drive compensation

  Overall growth remains steady, but pay for new urologists climbs dramatically Urology remains...

• DMAA’s report expands further into population health

  As population health programs grow across the industry, experts expect employers and health plans...