Package pricing: Geisinger's new model holds the promise of aligning payment with optimal care Jun 1, 2008 By: Julie Miller

Geisinger Health System and Geisinger Health Plan have attracted attention from key industry players ever since introducing a bundled-pricing program called ProvenCare in 2006. Richard Gilfillan, MD, president and CEO of Geisinger Health Plan, played a critical role in the launch of the new payment structure.

Welcome Back: Network Health Plan tracking number of disenrolled members who return to plans May 1, 2008 By: Julie Miller

Higher-than-expected enrollment has challenged the budget and the administration of public health coverage in Massachusetts ever since its universal health plan took effect in April 2006. Christina Severin, executive director of Network Health in Medford, Mass., a private plan that covers subsidized Commonwealth Care members as well as MassHealth Medicaid members, believes programs will continue to struggle until one particular problem is solved: enrollment churning.

Beware of barriers to care: Pitney Bowes increases access to care through on-site clinics and low-cost drug benefits Apr 1, 2008 By: Julie Miller

Employers are finding themselves between a rock and hard place when it comes to health benefits. If they reduce or eliminate benefits, they lose quality workers as well as productivity. If they maintain or increase benefits, they're almost certain to spend beyond their budgets year after year. In trying to strike a happy medium, more employers are now remodeling their health benefit plans dramatically, hoping to see better results.

Basic facts: Kaiser Family Foundation puts healthcare facts and figures at the fingertips of policy makers, MCOs, and the public Mar 1, 2008 By: Julie Miller

If you had $40 million to spend each year on a philanthropic mission in healthcare, what would your mission be? Helping the uninsured? Bankrolling demonstration projects? To deliver the greatest impact within the $2 trillion U.S. healthcare system, you would have to be choosy about your commitments.

Doctor driven: Physicians weigh tough decisions in CDPHP board rooms Feb 1, 2008 By: Julie Miller

Physicians' first-hand experience has no substitute, and Dr. William Cromie has maintained CDPHP's vision of including physicians in the governance of this health plan. Often, the plan and the physicians are faced with tough choices and collective compromises.

Increased insurance coverage should boost demand for medical services which would highlight concerns about access to medical care, particularly outside of Boston.

An important component of the legislation that has not received a lot of press to date has been the Health Care and Quality Cost Council (HCQCC) which was established by the same health reform law that created the Connector.

Perhaps it's no coincidence that former historian Jon Kingsdale, PhD, finds himself overseeing one of the most progressive healthcare initiatives in the country, the Massachusetts Commonwealth Health Insurance Connector Authority. The Connector facilitates the purchase of health insurance for individuals and small businesses across New England.

Condition dynamics: Patrick Hervy, CEO of XLHealth, grows DM company into Medicare special needs plan Nov 1, 2007 By: Julie Miller

Private sector organizations are pitching the government on new business, such as the recently embraced special needs plans (SNPs), designed for the costliest populations of seniors. Prompted by the Medicare Modernization Act, there are three SNP models: dual-eligible, institutional care and chronic condition.