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Managed Healthcare Executive E-News
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In this issue
• Marketing COBRA
• Poll: 26% of healthcare dollars spent unnecessarily
• Plans expand paperwork reduction initiative
• Eric Schultz leads Harvard Pilgrim Health Care
Key Topic Updates

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March 25 , 2010
Congress approves massive health reform bill
By Jill Wechsler
After months of increasingly rancorous debate, the House finally enacted legislation March 21 that makes significant changes in the nation’s healthcare system. The Senate is slated to approve the House-passed changes to its original reform bill shortly.
The legislation promises to expand the number of Americans with health coverage while reshaping the health insurance market as well as government health care programs.
A significant shortcoming in the legislation, which drew opposition from insurers and health plans, is that it does little to slow down the exponential rise in healthcare costs and spending. Insurers also fear that policies requiring individuals to purchase coverage are so weak that many healthy, young people will fail to enter the risk pool.
In addition, insurers will have to pay millions in fees to support expanded coverage, plus an additional tax on high-cost “Cadillac” health plans. At the same time, the legislation proposes substantial reductions in rates paid to Medicare Advantage plans, a prospect that is predicted to reduce access to and enrollment in private Medicare plans.
Implementation will be a huge challenge, especially for state governments. Republicans, as well as various interest groups, are already looking for revisions and challenges. Many provisions will not kick in until 2014, providing time to absorb potential changes but also creating uncertainty about the full impact of the legislation.
Insurers market alternatives to COBRA plans
By Jamie J. Gooch
Alternative short-term coverage costs less and lasts six to 12 months to fill in the gap between jobless and finding new employments. More...
Gallup poll: 26% of healthcare dollars spent on unnecessary medical care
By Jamie J. Gooch
One in four dollars spent on health care in America now pays for unnecessary tests and treatments that physicians order to keep from being sued, according to a new Gallup poll of the nation's doctors. More...
Plans launch pilot initiative in New Jersey to reduce paperwork
By Jamie J. Gooch
The pilot initiative is designed to make delivering and getting health care easier for patients and their physicians by reducing the time, effort, and expense for the paperwork required for each office visit. More...
Eric Schultz takes the helm of Harvard Pilgrim Health Care
By Jamie J. Gooch
Harvard Pilgrim Health Care Board of Directors has named Eric H. Schultz as its new president and CEO. More...
Key Topic Updates
Business Strategy
Payment reform redefines provider performance management
Michigan BOOST program aims to improve discharge transitions
Providers
Accountable care organizations could save Medicare 20%
Consumer experience provides worthwhile quality data
Pharmacy
Plans tread lightly when sharing utilization criteria online
Tuberculosis treatment requires medication and monitoring
Technology
Health IT data-sharing standards have implications for payers
Paying now and chasing later the worst way to counteract fraud

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