Health plan costs - managed care (BenefitsLink.com)Headlines re Health plan costs - managed care, gathered by BenefitsLink.comNew Products that Combine an HRA with an HMO Are Gaining Traction in California- (Found July 5, 2008 ) Excerpt: "Since being launched in June, a product that pairs an HMO with a health reimbursement arrangement (HRA) has been gaining sales traction in California, according to Health Net of California, Inc. The managed care company's Optimizer HMO is among a growing number of products that combine the features of an HMO or point-of-service (POS) plan with a health account." (Inside Consumer-Directed Care via AISHealth.com)http://www.aishealth.com/Bnow/hbd092107.html Pharmacist-Coordinated Health Management Delivers ROI (PDF)- (Found July 5, 2008 ) Pages 1-2 of pages. Excerpt: "While the health care costs for employees with chronic conditions will continue to be higher than average per employee costs, these pharmacist-coordinated programs are helpingto narrow the gap." (Pharmacy Benefit Management Institute, LP)http://www.pbmi.com/pbmnews/PBMInews_Summer_07a.pdf Companies Adopt Financial Incentives for Doctors- (Found July 5, 2008 ) Excerpt: "Beginning in 2008, IBM, Wachovia, Novant-Presbyterian Healthcare, Belk and Duke Energy will reward physicians who provide quality care based on national standards. The five Charlotte, N.C. area companies have partnered with the Charlotte Health Care Collaborative in an effort to improve quality care for their workers." (Employee Benefit News; free registration required)http://ebn.benefitnews.com/asset/article/160160/staying-current/companies-adopt-financial-... Managing Health Care Cost and Quality Through Predictive Data Analytics (PDF)- (Found July 5, 2008 ) 3 pages. Excerpt: "Read about how the emerging power of predictive analytics, coupled with advances in technology, can provide the tools and insight needed to effectively manage health care plans for the long term." (Aon Consulting)http://www.aon.com/about/publications/pdf/issues/ar_2007_07_managing_health_care_086.pdf California Regulators Faulted for Altering State Law on HMO Guidelines- (Found July 5, 2008 ) Excerpt: "Physician groups and patient advocates are criticizing the Department of Managed Health Care for failing to comply with a state law that seeks to improve timely access to care for HMO members, the Los Angeles Times reports." (California HealthCare Foundation; free registration may be required)http://www.californiahealthline.org/articles/2008/2/5/Regulators-Faulted-for-Altering-Stat... Healthcare Data Pooling: Coming Soon to a Community Near You- (Found July 5, 2008 ) Excerpt: "Everyone can agree that quality healthcare is a good thing. But how do we go about measuring quality Intrepid organizations in Massachusetts, Minnesota, Washington, and Wisconsin are answering the call for measurable quality metrics by developing data-pooling operations that can report on healthcare quality." (Milliman)http://www.milliman.com/expertise/healthcare/publications/published/Healthcare-data-poolin... Wal-Mart Signals Its Move Into the PBM Industry; Analysts Have Mixed Reactions- (Found July 5, 2008 ) Excerpt: "Wal-Mart Stores, Inc.'s plan to start offering pharmacy benefit services to employers has provoked mixed reactions from PBM industry stakeholders. While some observers contend that any move by the retail behemoth has the potential to be an industry 'game changer,' two of the largest PBMs appeared unfazed by the prospect of a giant new competitor." (AISHealth.com)http://www.aishealth.com/Bnow/hbd020708.html Guidance Overview Futility Doctrine Applied in Aid of Class Action Claims Against HMO Defendants- (Found July 5, 2008 ) Excerpt: "In this recent decision, the plaintiffs alleged that the defendant HMO's routinely overcharged for services. The defendants met these claims with a motion to dismiss for lack of subject matter jurisdiction and failure to exhaust administrative remedies. The plaintiffs prevailed on most issues in an decision that sheds light on Article III standing requirements and application of the futility doctrine." (Health Plan Law blog by Attorney Roy F. Harmon III)http://healthplanlaw.com/?p=634 Opinion Healthcare Reform -- Nobody's Asking the Hardest Question: Who Gets Care and When- (Found July 5, 2008 ) Excerpt: "I believe that without a mechanism to control what care is available and to whom and at what time, costs will continue to be a problem. We have more technology than we can afford. In national health care systems care is rationed by either long waits or guidelines that restrict access." (Jeffrey Clayton on the BNA Pension & Benefits Blog)http://pblog.bna.com/penben/2008/05/health-care---i.html High Healthcare Costs Caused in Part by Power of Healthcare Systems, Wisconsin Study Says- (Found July 5, 2008 ) Excerpt: "High health care costs in the Milwaukee area stem from the market power of health care systems, according to a study by the Wisconsin Policy Research Institute. The study contends that health care systems have increased their market power by employing physicians, which gives them a referral base for their hospitals, which makes it harder for would-be competitors to enter the market." (Milwaukee Journal Sentinel)http://www.jsonline.com/story/index.aspx?id=749172 |