US eke out small gains after Fed news Nov 5, 2009
09 after the managed care company posted a quarterly profit above analysts' estimates even as membership fell about 8 per cent from a year earlier. Intel Corp rose 1. (Sydney Morning Herald -- Business)
Today's Mailbag Nov 5, 2009
In my 37 years as a registered nurse and 24 years as a clinical social worker, I have worked both in hospitals, agencies and for managed care companies. I am appalled by the time, personnel and expense required by health care workers to secure and maintain authorizations, to care for their patients, from insurance and managed care companies ... The insurance company decides your treatment, based on information recorded in your medical records, as given over the phone, by a nurse, social worker... (The News-Press -- Opinion)
Ex-Illinois Attorney General Ryan launches bid for governor Nov 4, 2009
To close the gap, Ryan said he would cut spending and revamp the state's Medicaid system by moving more people into cheaper managed care programs. He also said he would change how retired state employees get their health insurance. (The Pantagraph newspaper)
AHCCCS director quits; replacement picked Nov 4, 2009
"It is going to be difficult for any successor to deal with the situation given the challenges that he will face," said Jim Hertel, publisher of "Arizona Managed Care Newsletter." "Given the current economy and its creation of a growing number of people who are in need of and eligible for AHCCCS care, it will be a tremendous challenge.". Brewer released a statement praising Betlach's financial and executive experience, adding that those qualities "will be a tremendous asset in these challenging... (AZCentral -- Business)
2 tough health care issues remain in the House Nov 3, 2009
Gypsy wrote on Oct 29, 2009 5:15 PM:" JB: The money the government wants to trim from Medicare comes from the Medicare "Managed Care" plans. The folks for these plans pay an exhorbitant amount each months, with large co-pays, deductibles, etc., under the erroneous idea that they are getting a "cadillac plan. "Well, maybe they are, but they do pay more for standard medical care.But, Medicare Advantage plans pay the costs of going to a gym and getting full workouts (that perhaps used to cost their... (Montana Standard, MT)
Prasco, Winthrop ink distribution deal Nov 3, 2009
The products are sold through distribution channels that include chains, independent pharmacies, distributors, wholesalers and managed care providers. Most Read Stories. (Cincinnati Business Courier, OH)
New mental health director faces difficult task, critics Nov 2, 2009
On the other hand, some mental health advocates are optimistic about the 55-year-old psychiatrist, whose experience includes management positions with a managed care insurance company and a firm that helped improve state Medicaid and mental health offices in 28 states. I think he's trying new things, and I'm hopeful they are the right things, said Ellyn Jeager of Mental Health America of Georgia, a nonprofit advocacy group. (Atlanta Journal-Constitution -- Metro)
House Calls As Cost-Saver In Health Reform? Nov 2, 2009
It's not an image many of us can conjure in an era of overcrowded ERs and specialty clinics and the type of "managed care" that often means a long wait in a sterile reception room followed by a hasty examination. The visiting doc went out not long after the horse and buggy, as technology advanced and institutionalized health care became the norm. (Click2Houston, TX)
Sen. Richard Tisei: Fiscal crisis demands state's immediate action Nov 1, 2009
We also need to move the state s Medicaid recipients into managed care plans to rein in health care costs, which should save about $250 million. And while we re at it, we should repeal the anti-privatization Pacheco Law, which could easily save taxpayers $250-$500 million. (Reading Advocate, MA)
Medicare Advantage may lose luster Nov 1, 2009
The managed care plans also have been shown to be effective. A Johns Hopkins University study released in September by the Alliance of Community Health Plans showed that in the Medicare Advantage plans it examined, hospital readmissions were 27 percent lower than in traditional Medicare plans. (Pittsburgh Post-Gazette, PA)
Todobebe and Molina Healthcare Produce National Public Service Announcements Oct 30, 2009
Molina Healthcare, Inc. (NYSE: - ) is a multi-state managed care organization that arranges for the delivery of healthcare services to persons eligible for Medicaid, Medicare, and other government-sponsored programs for low-income families and individuals. Molina Healthcare has licensed health plan subsidiaries in California, Florida, Michigan, Missouri, New Mexico, Ohio, Texas, Utah and Washington and currently serves approximately 1. (Yahoo! Wire -- Entertainment News)
P&G earnings beat analyst forecasts Oct 30, 2009
Managed care company heads into the final quarter of 2009 fighting swine flu and rising unemployment like the other major health insurers. But the Hartford insurer s third-quarter profit grew 18 percent, and executives said yesterday they finally have a handle on rising medical costs, which have hurt performance in the past couple of quarters. (Boston Globe)
Schneck supervisor named to Medicaid study committee Oct 30, 2009
Warren Forgey, vice-president of fiscal services/treasurer, said Somes was appointed to the Medicaid managed care quality strategy committee by B. Patrick Bauer, speaker of the house of representatives of the Indiana General Assembly. Somes is one of only three Indiana hospital representatives named to the committee. (Brownstown Jackson County Banner, IN)
Walking to feed the hungry Oct 29, 2009
- Altamese Harley (center), Division Officer of Managed Care at the Naval Branch Health Clinic, Terry Jones (left), a contractor supporting Submarine Development Squadron TWELVE, and Cindy Trobaugh (right) walk the last half mile of the six-mile CROP Walk in Gales Ferry Oct. 18. Just under 100 walkers registered for pledges and braved the chilly temperatatures and rain to raise money for local and international food organizations to feed the hungry. (The Dolphin, CT)
Bundling Two Low-cost Heart Drugs Prevents Heart Attack And Stroke In Large, Diverse Population Oct 28, 2009
28, 2009) A program that bundled two generic, low-cost drugs a cholesterol-lowering statin and a blood pressure-lowering drug and gave daily doses to 68,560 people with diabetes or heart disease for two years is estimated to have prevented 1,271 heart attacks and strokes in the first year following the study period, according to a Kaiser Permanente study published online in the American Journal of Managed Care. See also. (Science Daily)
Balser: A record of accomplishments driving a vision for the future Oct 28, 2009
As the director of mental health services and as a manager in a behavioral health managed care organization, I was responsible for managing resources, while ensuring quality services were delivered to consumers. This experience and talent to get things done has prepared me well for the job of mayor. (Newton Tab, MA)
Ethicon: Surgery style shows benefits Oct 27, 2009
The retrospective analysis was performed on 15,404 patients using claims data from a large U.S. managed care plan. The results of the study, which was sponsored by Ethicon Endo-Surgery, were published in the September issue of The Journal of Minimally Invasive Gynecology. (Cincinnati Business Courier, OH)
Health care affordability matters most Oct 27, 2009
The state Health Department's 2008 Managed Care Annual Enrollment Trend Report shows a selection of health plans in the various counties cited by Breslin and Schneiderman -- more than half a dozen in both Albany and Onondaga counties and nearly that many in Erie, all areas where they claim only one insurer has between 79 percent and 87 percent of the market ... It represents 25 managed care health plans across New York, which serve nearly 7 million New Yorkers. (Albany Times Union)
Nightmare after surgery Oct 26, 2009
And the American Journal of Managed Care in September 2008 published a study that concluded the cost of bariatric surgery is recouped within two years if the patient has a laparoscopic procedure, with small incisions, and in four years if it's an open procedure with a larger incision. Ironically enough, Smith's surgery was covered by her parents' insurance when she had it in 1999. (Daytona Beach News Journal)
New database brings Cincinnati doctors out of the dark Oct 25, 2009
Managed care consulting firm has created a database that compares average reimbursement amounts in Cincinnati and seven other cities for 450 types of procedures and visits. The company is selling a subscription service to practices that want to make sure their payment is up to par. (Cincinnati Business Courier, OH)
Earnings reports to give picture of job market Oct 25, 2009
Managed care company UnitedHealth Group Inc. saw its third-quarter profit jump 13 percent, as growth in several businesses helped balance another enrollment decline and fight off a touch of swine flu. The Minnetonka, Minn. (Fresno Bee -- Business)
Emerging care model focuses on prevention, managing chronic conditions Oct 25, 2009
The HMO's pilot program, begun in early 2007, reduced emergency room visits by 29 percent and hospitalizations by 11 percent while improving quality of care, according to a September report in the American Journal of Managed Care. How does Group Health do it. (Herald Online, SC -- Lifestyles)
Lawmakers, don’t focus on fluff Oct 25, 2009
We also need to consider moving the state s Medicaid recipients into managed care plans to rein in health care costs, which make up a significant portion of the budget. And while we are at it, we should repeal the anti-privatization Pacheco law, which costs taxpayers hundreds of millions of dollars. (Boston Globe)
Melrose Mayor: state budget cuts would equal local layoffs Oct 23, 2009
He also called for putting all the Medicaid recipients into managed care and selling state assets that are no longer needed. Every business and family has adjusted their spending habits and their budgets to get by, Tisei said, The state hasn t done that. (Melrose Free Press, MA)
Lilly posts 3Q profit; analysts doubt future sales Oct 22, 2009
Company officials told analysts the launch was proceeding as scheduled, and they were meeting with hospitals and managed care companies to negotiate pricing and access, a process that could take several months. Edward Jones analyst Linda Bannister said she expected more progress from Lilly. (Yahoo News -- Pharmaceutical Industry News)
Coming events Oct 20, 2009
PARADISE TOASTMASTERS, 5 to 6 p.m., Tripler Army Medical Center, Managed Care conference room. 487-8703. (Honolulu Advertiser)
Beacon Hill Roll Call: Legislature debates animal control laws Oct 20, 2009
Gov. Patrick's Fiscal Management Plan fails to include such basic actions as a state hiring freeze, a state wage freeze, any managed care reform, or a repeal of the anti-privatization law that is costing the state's taxpayers hundreds of millions of dollars a year. Senate Minority Leader Richard R. Tisei (R-Wakefield). (Needham Tab, MA)
Beacon Hill Roll Call: Senate rejects new dog fee system Oct 17, 2009
Patrick's Fiscal Management Plan fails to include such basic actions as a state hiring freeze, a state wage freeze, any managed care reform, or a repeal of the anti-privatization law that is costing the state's taxpayers hundreds of millions of dollars a year. " Senate Minority Leader Richard R. Tisei (R-Wakefield) "I am flattered that his (Patrick's) fiscal crisis management plan includes so many Republican proposals that were offered back in April during budget debate including; expediting the... (Cambridge Chronicle, MA)
Medicare Advantage changes hit 2,500 Franklin County seniors Oct 17, 2009
Also, insurers are getting ready to phase out fee-for-service plans under federal orders and migrate customers to managed care plans. Aetna also intends to add customers from the plans exiting Ohio, he said. (Columbus Business First, OH)
Molina Healthcare, Health Alliance partner Oct 17, 2009
is a managed care organization with members in California, Florida, Michigan, Missouri, New Mexico, Ohio, Texas, Utah, and Washington. Most Read Stories. (Cincinnati Business Courier, OH)
Md. health plans below national average Oct 16, 2009
Maryland residents rated their managed care plans lower than the national average, according to report released Thursday by the. About one-third of Maryland residents rate their health plan a "9" or "10" on a scale of 1-10, compared with about 40 percent of health maintenance organization members nationally. (Baltimore Business Journal, MD)
Insurers' Health Reform Attack Draws Fire Oct 13, 2009
Managed Care Magazine also says that the average executive compensation (excluding unexercised stock options) for an executive of a. top 10 for profit health plan. (CBS News)
> Roundtable: Brass tacks with Silicon Valley hospital CEOs Oct 12, 2009
Pich;: This is the most mature managed care market I ve worked in my career. Managed care has tended to suppress physician incomes. (San Jose Business Journal, CA)
Highlights of 2009-10 spending plan agreement Oct 10, 2009
9 percent gross receipts tax on some managed care organizations to raise $316 million, replacing an expiring assessment. Redirects 2 percent of slot-machine gambling revenues into the states general fund for four years; the money currently benefits Pennsylvanias race horse industry. (Carlisle Sentinel, PA)
Sector Roundup: Entertainment, Managed Care Oct 9, 2009
Sector roundup: Entertainment stocks rise on improved ad outlook, health insurers fall. October 8, 2009 (AP) The Associated Press. (ABC News -- Wire)
Letters to the editor Oct 8, 2009
Managed care was supposed to reduce costs, but the insurance companies only increased their profit and decreased our access and level of care. Why let these companies continue to fail at our expense. (NJ.com -- Times)
Molina's Medicaid health plan earns accreditation Oct 7, 2009
is a multi-state managed care organization that delivers health care services to individuals eligible for Medicaid, Medicare and other government sponsored health plans. The company s health plans are licensed in California, Florida, Michigan, Missouri, New Mexico, Ohio, Texas and Utah. (San Antonio Business Journal, TX)
Is Congress Giving States Too Much Power on Health-Care Reform? Oct 7, 2009
Cantwell based her amendment on a program that already exists in her home state of Washington; called Basic Health Plan, it pools non-Medicaid-eligible low-income residents, steering them into lower-cost managed care plans. Critics point out that premiums for these low-income residents have still risen dramatically since the program launched in the early 1990s, but Cantwell and Baucus say they have been assured informally by the Congressional Budget Office that if states chose to pool residents... (Time.com)
Chester County Hospitals relationship with Keystone Mercy Medicaid HMO ends Oct 7, 2009
Anne Morrissey, president of Pennsylvania managed care at Keystone Mercy, in August said the company had a good relationship with Chester County Hospital. However, she said, we cannot afford the commercial-based payment levels they required. (Philadelphia Business Journal, PA)
Pfizer Wins While CVS Loses as Senate Considers Obama-Led Health-Care Plan Oct 6, 2009
The public plan was always the nuclear scenario for managed care, Sullivan said. Without it, the changes are all something the industry can learn to live with. (Bloomberg -- US)
Rendell says budget close, urges cooling off Oct 6, 2009
Whether a true agreement is in the works remains anybody s guess. Gov. Ed Rendell said a deal was close, but previous signs of progress have not produced a comprehensive spending plan for the 2009-10 year that began July 1. (Somerset Daily American, PA)
Cheap Three-Drug Combination Helps Cut Heart Risks Oct 3, 2009
"Even in people who took it less than half the time, they got over a 60 percent drop in heart attacks and strokes," said Dr. R. James Dudl of Kaiser Permanente in California, whose study was published in the American Journal of Managed Care. "Those who took it more than half the time -- they got more like an 80 percent drop," Dudl said in a telephone interview. (MEDLINEplus)
Cheap Three Drug Combo Slashes Heart Risks Oct 3, 2009
"Even in people who took it less than half the time, they got over a 60 percent drop in heart attacks and strokes," said Dr. R. James Dudl of Kaiser Permanente in California, whose study was published in the American Journal of Managed Care. "Those who took it more than half the timethey got more like an 80 percent drop," Dudl said in a telephone interview. (Newsmax)
Democrats Ease Impact of Health Bill Oct 3, 2009
The Cantwell proposal is based on a system in Washington state that she said results in lower-cost, high-quality coverage, generally delivered through managed care, as the state uses its purchasing power in negotiations with insurers. Republicans questioned whether the impact would be to raise insurance premiums for others, and said they were fearful the result would be to reduce health care options. (Time.com)
Slusser leaving Centene Oct 3, 2009
St. Louis-based Centene Corp. (NYSE: CNC), led by Chairman, President and CEO Michael Neidorff, provides managed care programs and related services to individuals under Medicaid. It also operates health plans in Georgia, Indiana, New Jersey, Ohio, Texas and Wisconsin. (St. Louis Business Journal, MO)
CNA - Certified Nursing Assistant / Caregiver Oct 3, 2009
Job Snapshot Location: Jackson, Madison, Brandon, Canton, Pearl, Ridgeland, MS 39211 Other Pay: Hourly Rate and Referall Bonus Opportunity Employee Type: Full-Time/Part-Time Industry: Healthcare - Health Services Managed Care Social Services Manages Others: No Job Type: Health Care Nurse Customer Service Experience: 1 to greater than 15 years Post Date: 9/6/2009 Description. CNA Certified Nursing Assistant / Caregiver. (The Clarion-Ledger)
Obamacare: Cut the Elderly and Give to AARP Oct 3, 2009
It combines all the elements he likes -- premiums are subsidized for low-income elderly, and the companies negotiate low-priced, managed care that emphasizes prevention, treatment of chronic conditions and coordination among doctors. As a result, its costs on the one hand and its premiums on the other are both much lower than with conventional insurance. (Townhall.com)
ObamaCare Shenanigans Oct 3, 2009
Managed care provider Humana published a letter to its members warning them of potential drastic cuts to Medicare (specifically the Medicare Advantage program) under ObamaCare. It urged its members to contact Congress. (Townhall.com)
Trimming Health-Care Costs Without Reforming the System Oct 2, 2009
The American Journal of Managed Care. by researchers from. (BusinessWeek)
Senate panel approves Cantwell amendment Oct 2, 2009
"The adoption of her amendment, along with a change in the Medicare reimbursement rates that could benefit Washington state, will be enough for Cantwell to support Baucus' bill. Several weeks ago Cantwell said she couldn't support legislation that didn't include a public option and the change in Medicare reimbursement."This is a foothold in a big mountain to climb," Cantwell said, adding that though the Baucus bill could still be improved, she will work to support it.The committee could vote on... (Fresno Bee)
UPMC Health Plan asks for OK to raise rates 48 percent Oct 2, 2009
HMOs are the most restrictive form of managed care, requiring members to receive care from approved doctors. The base rate is used to compute premiums for various products, with a 15 percent variability allowed by the state, according to Tony Benevento, vice president of commercial sales. (Pittsburgh Business Times, PA)
Less Than Half Of U.S. Medical Students Understand Health Care System, Study Finds Oct 1, 2009
But when it came to understanding health economics, the health care system, managed care, managing a practice or medical record-keeping, 40 percent to 50 percent of students reported feeling inadequately prepared. The findings were published this month in Academic Medicine. (Science Daily)
Executive Director/Nursing Home Administrator Oct 1, 2009
Employee Type: Full-Time Industry: Healthcare - Health Services Managed Care Other Great Industries Manages Others: Yes Job Type: Health Care Management Executive Experience: Not Specified Relocation Covered: Yes Post Date: 9/30/2009 Contact Information Contact: Rick Smith Phone: NO CALLS PLEASE Ref ID: FAIRFIELD ED Fax: 205-449-8353 Description. EXECUTIVE DIRECTOR. (Florida Today)
Physician Reimbursement and Their Practice Survival Defended by American National Medical Management Sep 24, 2009
"Physicians are at breaking point in their business survival as a result of underpayment and denial of managed care claims," states Gregory Maxon Maldonado. "The Center for Health Insurance Claims Advocacy is an organization with a proven track record for enforcing healthcare reimbursement regulations". (PR Newswire)
Biden Tells Nervous Seniors Obamacare Won't Hurt Sep 24, 2009
On Tuesday, Congress' chief budget analyst, Douglas Elmendorf, contradicted the White House, saying seniors in Medicare's managed care plans could see reduced benefits under a bill in the Senate Finance Committee. Biden acknowledged that polls show seniors are some of the most skeptical about overhauling health care, but he argued that seniors would benefit from the changes. (Newsmax)
Kentucky Chamber addresses Medicaid Sep 24, 2009
Expanding managed care, emphasizing wellness and providing stop-smoking programs are among strategies that Kentucky should consider to address spiraling Medicaid costs, the said Wednesday. In a speech to the Paducah Rotary Club, chamber president and CEO Dave Adkisson said rising Medicaid costs are shifting state funding away from education. (Louisville Business First, KY)
Senators spar on health bill's effect on seniors Sep 24, 2009
Budget Director Douglas Elmendorf said the cuts could reduce the generous benefits that the seniors in Medicare's private managed care plans enjoy. GOP senators pushed amendments Wednesday meant to block the bill's proposed changes to Medicare. (USA Today -- News)
> Norton Healthcare canceling Anthem contract early Sep 24, 2009
Jim Meyers, Norton s associate vice president of managed care, said the company decided to exercise an option to back out of its contract with Anthem and notified the insurer late last year that it no longer would provide services under the current contract as of June 30. He said company officials would like to negotiate a new contract with Anthem prior to July 1. (Louisville Business First, KY)
Administrator discusses budget for Countryside Sep 23, 2009
Further, the Managed Care Organization does not cover any of their costs when one of their members is placed at one of these institutions. The cost would be the responsibility of Jefferson County. (Watertown Daily Times, WI)
Vucurevich joins Prasco as senior VP Sep 23, 2009
With over 25 years of industry experience, he possesses a vast knowledge of the regulatory environment, managed care and retail pharmacy ... The products are sold through distribution channels that include chains, independent pharmacies, distributors, wholesalers and managed care providers. (Cincinnati Business Courier, OH)
Budget chief contradicts Obama on Medicare costs Sep 23, 2009
The head of the nonpartisan Congressional Budget Office, Douglas Elmendorf, told senators that seniors in Medicare's managed care plans could see reduced benefits under a bill in the Finance Committee. The bill would cut payments to the Medicare Advantage plans by more than $100 billion over 10 years. (WCAX.com, VT)
Pediatric Strokes More Than Twice As Common As Previously Reported Sep 22, 2009
3 million children from 0 19 years old enrolled in the Kaiser Permanente managed care plan in Northern California from1993 2003. Researchers searched for stroke cases in two ways: using International Classification of Diseases, 9th division (ICD-9) codes (diagnostic codes entered on medical charts primarily for billing purposes) and keywords suggesting a stroke on radiology reports computerized tomography (CT), magnetic resonance imaging (MRI), and angiograms. (Science Daily)
California Medical Association names Gilchrist as CEO Sep 22, 2009
He worked on issues ranging from managed care contracting practices to physician profiling and rating systems, health plan mergers and acquisitions, and expansions and reforms to Medicaid, the government health care program for the poor. I am honored and humbled to step into this role in this great state, Gilchrist said in a news release. (Sacramento Business Journal, CA)
MedAssurant seeks space to expand after acquisition Sep 21, 2009
MedAssurant provides data analysis of health care treatment methods, their clinical results, their costs and their potential cost savings, mostly for insurers and public and private managed care entities ... With the Catalyst acquisition, Dunleavy said, MedAssurant will be hunting for more high-tech, well-paid statisticians, researchers, actuarial experts, data analyzers and clinical personnel to round out a staff whose client list has jumped to more than 200, including some of managed care s... (Washington Business Journal, DC)
Editorial: 'Big 6' too small to fix health care Sep 21, 2009
In 2003, Congress passed Medicare Advantage, with subsidies (totaling $15 billion to $17 billion a year) to attract private managed care plans. Enrollments boomed, particularly in California. (Sacramento Bee -- Opinion)
