Insurance companies bracing for change in healthcare reimbursement

At Modern Healthcare, they look at how new legislation implementing universal healthcare will affect how insurance companies are going to be affected when the new plan roles out, which many believe could be as soon as 2011. In addition to the abundance of regulations that are sure to follow, insurance companies will have to change the way they evaluate hospitals. They could begin paying for care based on performance and begin listening to independent patient advisory boards. They could also change they way they reimburse hospitals when it comes to re admissions for certain ailments. Read the full article here.

Obama's Health Care Bill Narrowly Passes in House

President Obama praised the House yesterday for narrowly passing his healthcare bill. The count was extremely close - 220 to 215 with only one Republican voting yes. The $1.2 trillion bill is aimed at expanding coverage to 36 million uninsured Americans and the plan will also cut spending by $400 billion over the course of a decade. Take a couple of minutes to view the coverage by CBS News below.

The current state of healthcare reform -- Are you ready?

Are you ready for the Healthcare reform?

If a bipartisan agreement is not reached by October 15th, a republican filibuster is not possible and healthcare reform is a done deal with 50 votes in the Senate. With the democrats holding 58 seats, it is irrational to think some level of reform will not happen this year. While it is difficult to predict what the final bill will look like, every reform proposal currently under consideration mandates individual coverage and ends barriers to coverage for people with preexisting medical conditions. If no other policy reforms are included in the final bill, the ramifications for the health insurance business are still tremendous.

How will Health Plans survive this direct hit on their current business model?

Through the vital restructuring of the healthcare delivery models they currently employ and the Next Generation Healthcare Delivery event, scheduled for October 26-27 in Washington, DC. This is your best opportunity to convene with other health plan leaders from across the nation to evaluate and integrate innovative healthcare delivery models to ensure sustainability and profitability in the years to come.

How will Health Plans expand coverage to previously uninsurable populations and maintain profitability?

Traditional medical management has been maxed out, if health plans want to survive, it is essential that they act now to incorporate value-based benefit design and outcomes driven provider structures that ensure that health and wellness are managed effectively and efficiently. At the Next Generation Healthcare Delivery join your industry colleagues at this critical crossroads and reshape your current provider model by taking simple steps to obtain measurable improvements in clinical outcomes.

• Utilize Shared-decision making and let patient choice lead to the use of less costly healthcare delivery options
• Incorporate Medical Home Models to support a better organization of care and gain ideas to make it more effective
• Implement value-based tools to manage risk and help members make better choices
• Leverage ways that e-visits can increase access to specialty care while maintaining lower cost structures
• Develop a value-based integrated health care delivery system for the future

The moment is now. Register for Next Generation Healthcare Delivery and evolve your business into a true partner in care delivery and improved health outcomes!

Healthplans must integrate these delivery models by redesigning their benefits and reimbursement structures. The Next Generation Healthcare Delivery event provides you with the tools you need to implement and integrate new delivery models into your program benefit design for better health outcomes, higher member satisfaction, and a greater competitive advantage.

Through pilot programs, case studies, panels and roundtable discussions, our expert speaking faculty shares best practices and RESULTS on new delivery models and how they can improve healthcare quality while maximizing ROI.

Register today!


To become more involved with other professionals working in the next generation healthcare delivery field, join our LinkedIn Group!

Government Run Healthcare

According to Thomas DiLorenzo's post in the Ludwig von Mises Institute blog the more money we have spent on government-run healthcare in the past, the less healthcare we have gotten in return. He mentions that since there are no profits, there is no rewarding system that penalizes for bad performance and encourages good performance. Thomas notes that the federal government is actually doing the opposite, giving higher budgets to those hospitals that are failing in performance and reducing budgets for those that are performing well. Here are some examples Thomas including in his post from a NY Times article entitled "Full Hospitals Make Canadians Wait and Look South"

* A 58-year-old grandmother awaited open-heart surgery in a Montreal hospital hallway with 66 other patients as electric doors opened and closed all night long, bringing in drafts from sub-zero weather. She was on a five-year waiting list for her heart surgery.

* In Toronto, 23 of the city's 25 hospitals turned away ambulances in a single day because of a shortage of doctors.

* In Vancouver, ambulances have been "stacked up" for hours while heart attack victims wait in them before being properly taken care of.

* At least 1,000 Canadian doctors and many thousands of Canadian nurses have migrated to the United States to avoid price controls on their salaries.

What's your take on socialized healthcare?

New Health Care policies proposed in the Senate

Recently at the New York Times, they looked at the new proposal by was made Monday by Senator Charles E. Schumer of New York. The Senate began discussing this issue yesterday. Read the full story here.