While the U.S. House and Senate wrangle over the final healthcare bill, health plans aren't sitting idly by waiting for the future to arrive.
While the U.S. House and Senate wrangle over the final healthcare bill, health plans aren’t sitting idly by waiting for the future to arrive. There are a number of trends plans can expect to affect business in 2010 and beyond.
The economy is still a wild card, but is showing signs of recovery. If the economy does improve, and more jobs are created, then health plan membership will also improve. If the economy doesn’t continue to improve, health plans must be prepared to focus even more on retaining and attracting members, according to Tom Epstein, vice president for public affairs, Blue Shield of California.
“Health plans need to develop products that are easy to understand and administer to prepare for the exchange environment,” he says. “We must also take strong action to hold the line on costs while improving care coordination and incentivizing quality care.”
Epstein says health plans will continue to seek partnerships and try new programs and technologies to improve the quality of care and lower costs.
“At Blue Shield we are piloting a new program with a medical group and a hospital where we all share the risk for providing coordinated care at a lower cost for a major customer,” he says. “Health plans will also bring more processes online to provide faster and more accurate service at a lower cost.”
In this second part of a two-part podcast episode, Managed Healthcare Executive's Managing Editor Peter Wehrwein spoke with Ceci Connolly and Margaret "Meg" Murray about Medicare Advantage utilization and challenges, highlighting proposed CMS payment cuts and prior authorization issues.
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The Departments of Health and Human Services (HHS), Labor, and the Treasury, released final rules on short-term, limited-duration insurance (STLDI) and independent, non-coordinated excepted benefits coverage, addressing issues related to the low-quality insurance, or "junk insurance" plans.
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In this first part of a two-part podcast episode, Managed Healthcare Executive's Managing Editor Peter Wehrwein kicks off our new podcast series "DC Roundtable," with guests Margaret "Meg" Murray, CEO of the Association of Community Affiliated Plans, and member of MHE's Editorial Advisory Board, and Ceci Connolly, president and CEO of the Alliance of Community Health Plans, for a discussion on healthcare policy issues.
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2024 Emerging Leaders in Healthcare — Submit For a Chance to Be Featured in MHE's August Issue
March 28th 2024MHE Editors are seeking diverse healthcare professionals from different backgrounds and healthcare sectors, with individual interests. Eligible candidates are early or mid-career leaders with less than 10 years of experience. Award winners will enjoy complimentary passes to the PBMI Annual National Meeting in Orlando, Florida, from Sept. 4-6. Additional perks include a feature in our August issue, a subscription to MHE and more!
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Muthiah “Muthu” Vaduganathan Discusses the Role of SGLT2 Inhibitors in Heart Failure Treatment
March 27th 2024Editors of Managed Healthcare Executive spoke with Muthiah “Muthu” Vaduganathan MD, MPH, consultant cardiologist at Brigham and Women's Hospital and a member of faculty at Harvard Medical School, about the evolving treatment landscape for heart failure, emphasizing the use of SGLT2 inhibitors alongside other foundational therapies.
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