Health Plans/Managed Care

Health care solutions and benefits management for employers and HR teams. Providing direction on health care consumerism and population health and wellness.

Health Plan / Managed Care





Cleveland Clinic Creates Center for Personalized Health Care
Innovative Center to Centralize Focus on Patient-Physician Collaboration

Blue Cross and Blue Shield of Florida Health Plans Now Available Through eHealthInsurance.com
eHealth, Inc., the leading online source of health insurance for individuals, families and small businesses, announced that it is offering individual and family health insurance plans from Blue Cross and Blue Shield of Florida through the company's primary retail website, http://www.ehealthinsurance.com.

Walgreens Take Care Health Systems, Intel Expand Relationship by Opening On-Site Medical Center
Health for Life Center in Hillsboro, Ore. Offers Full Service Primary Care to 5,700 Employees

Hythiam Announces Catasys Contract with Coventry Health Care, Inc. Unit
Hythiam to Receive Monthly Fees Per Enrolled Member under Multi-Year Services Agreement

UPMC Health Plan Introduces UPMC MyHealth Connect
Provider Directory Is First Offering on New Mobile Application

Medica and Mayo Clinic Expand Relationship
Members to Gain In-Network Access to Mayo Clinic, Rochester, Minn.

Workplace Clinics a Sign of Growing Employer Interest in Wellness, But Cost-Saving is Limited
Interest in workplace clinics has intensified in recent years, with employers moving well beyond traditional niches of occupational health and minor acute care to offering clinics that provide a full range of wellness and primary care services, according to a study from the Center for Studying Health System Change (HSC).

Aetna Accountable Care Organizations Proving That Improved Quality, Lower Costs Are Possible
Aetna is building on Medicare Advantage ACO model success

Medicare Enrollment: Survey Finds Majority of Seniors Do Not Plan to Review Their Coverage Options
Only one-in-five (22 percent) Medicare beneficiaries over the age of 65 plan to review their Medicare coverage options during Medicare's 2011 Annual Enrollment Period (11/15/2010 to 12/31/2010), according to a new survey(1) of Americans age 65 and over conducted in December 2010 by Opinion Research Corporation.

Physician Groups Join Forces to Improve Care
Vista Health System IPA (VISTA) and Central Jersey Physician Network IPA (CJPN) announced the formation of Optimus Healthcare Partners LLC, an Accountable Care Organization (ACO).

Live, Online Access to Minnesota Doctors Offers new Holiday Convenience
Blue Cross and Blue Shield of Minnesota introduces Online Care Anywhere to all Minnesotans

All is not Fair in Health and Financing…but it can be.
Wrestling the continually hulking health care cost gorilla has led to some elusive survival tactics by agile employers – massive cost shifting and benefit plan tweaks so deep into the minutia, employees need a GPS unit, microscope, and personal accountant to wend their way through their plan design

Highmark Inc. Chooses Verisk Health to Streamline Its Quality Measurement and Reporting
Verisk Health’s HEDIS reporting suite completes NCQA certification and continues its long-standing position as a NCQA beta-testing solution

Majority of Employers to Keep Health Plans Rather than Encourage Employees to use State Exchanges
Employers appear poised to keep their employer-sponsored group medical plans intact rather than encouraging employees to use state health insurance exchanges when they become available in 2014, according to the "Health Care Reform Survey 2010" released by the Willis Human Capital Practice.

Consumer Driven Health Plans Surge as Employers Demand More For Less
A DataPath Advertorial

Practical Tools, Timely Information Enable Thompson Machinery to Boost CDHP, Control Cost
In 2003, Thompson Machinery, a Caterpillar equipment dealer for middle and western Tennessee and northern Mississippi, did what only a handful of innovative companies had done when it successfully implemented a consumer-directed health plan (CDHP) for employees.

Guardian Introduces New Multi-Coverage Voluntary Plan
New Voluntary Option Enables Employers to Create Customizable Benefits Packages

The Future of American Health Care
This is not a post about predicting the future.

HealthPartners Launches Virtuwell.com in Wisconsin
24/7 online clinic offers fast diagnosis, treatment and prescriptions for 30 simple conditions

Striking a Balance: How Employers Can Make the Best Decisions on Grandfathering Their Health Plan
The interim regulations on grandfathered plans under the Patient Protection and Affordable Care Act (PPACA) are designed to allow employers to keep their current plans intact and at the same time ensure that employees are protected from significant loss of benefits or increased costs.

Several Million Californians Lack Access to Job-Based Coverage
Most working-age adults have little success securing other coverage, Center study finds

2011 Health Care Benefits Forecast: How Employers can Manage Rising Costs
Employee Benefit Expert Offers Cost-Cutting Tips to Business Owners, HR Professionals

Health Care and Dental in Health Reform
Now that the new health care legislation is the law of the land, health care companies and businesses everywhere are scrambling to make sense of the thousands of pages that make up the bill. One major consideration for people to decipher is about dental care.

Health Care Reform: Consumer Pulse Survey
The Deloitte Center for Health Solutions (DCHS), part of Deloitte LLP, conducted a survey of consumers Sept. 29 through Oct. 4, 2010, to assess their awareness and expectations about health reform, more than six months after the Patient Protection and Affordable Care Act (PPACA) was signed into law.

Many Important Health Insurance Choices Must Be Made Now in Georgia
Open Enrollment Season is in Full Swing and Employees are Making Their 2011 Health Plan Choices

EBRI: Public Opinion of New Health Care Reform Is Limited, Varies by Plan Type, Political Party
Although most people's knowledge of the new health care law is limited, their opinion on how it will affect their health care depends on what type of private health insurance plan they currently have and their political affiliation, according to a recent report issued by the nonpartisan Employee Benefit Research Institute (EBRI).

Medco's 2011 National Medicare Prescription Drug Plan (PDP) Earns CMS 5-Star Quality and Performance
Medco Health Solutions, Inc. (NYSE: MHS) announced that its 2011 Medco Medicare Prescription Plan earned the Center for Medicare and Medicaid Services' (CMS) highest overall quality and performance rating – 5 Stars – for its national Prescription Drug Plan (PDP).

CIGNA and Merck Help Customers Better Manage Diabetes
Model Program Improves Health Outcomes and Reduces Overall Costs

Employers Build Plan Survival Strategies as They Assess the Financial Impacts of Health Reform
With sweeping health reform legislation complete, employers are considering critical questions about the financial future of their employer-sponsored medical plans.

Colorado Employers' Health Care Benefits Costs Trending Significantly Above National Norms
The Lockton Benefit Group in Denver announced the results of its tenth annual Colorado employer survey regarding health benefit costs and coverage.

Three Million Californians use Health Plans with High Out-of-Pocket Costs
Costs may cause members to delay care, put families in financial jeopardy

Medagate and InComm Launch OTCNetwork
The First National OTC Benefits Disbursement & Redemption Network for Medicare Advantage Plan Members Provides Leading Medicare Advantage Plans, Health Plus Elite and Access Medicare, Leverage New OTCMedicare Prepaid Card to Reduce Member Health care Costs

Nation’s Largest Health Plan Survey Cites Significant Health Plan Cost Disparity Between States
Creating Parity through a National Plan May be Difficult

Unique Consultancy for Health Care Provider Organizations Facing “Apex Decisions” in the Post-Reform
Health care is the largest and fastest growing U.S. business sector, with a $2.4 trillion annual spend representing more than 17 percent of national GDP.

A Nation of Health Reform Violators
By Ronald E. Bachman FSA, MAAA, chairman CDHC Solutions editorial advisory board

Kaiser Permanente's ALL/PHASE Initiative Wins 2010 Care Continuum Alliance Quality Impact Award
Program focuses on sharing low-cost protocols proven to reduce heart attacks

AT&T Selects WellDoc Mobile Health Solution for Management of Chronic Diseases
AT&T and WellDoc
Implementing Parity: The Safe Harbor for Outpatient Benefits
The U.S. Department of Labor (DOL) posted the following compliance assistance on its website on July 1, 2010: Until the issuance of final regulations, the Agencies have determined that they will establish an enforcement safe harbor under which the Agencies will not take enforcement action against a plan or issuer that divides its benefits furnished on an outpatient basis into two sub-classifications for purposes of applying the financial requirement and treatment limitation rules under MHPAEA: (1) office visits, and (2) all other outpatient items and services.

Principal Jettisons Health Insurance Unit
Principal Financial Group Inc. is getting out of the medical insurance and self-insured plan administration businesses, and it has arranged for UnitedHealth Group Inc. to handle renewals.

New Data: Millions of Americans With Alcohol & Drug Addiction Could Benefit From Health Care Reform
Proper Implementation Critical to Making Gains

Large Employers’ 2011 Health Plan Design Changes
The National Business Group on Health conducted its annual plan design survey with members in the spring/summer of 2010. This survey is one of the few surveys conducted mid-year just as employers are finalizing their plan designs for the following year.

Guidance on Annual Limit Waivers Released
On September 3, 2010, the Department of Health and Human Services (HHS) released guidance on how to apply for a waiver of the rules under the Affordable Care Act on restricted annual dollar limits, which are applicable for plan years beginning on or after September 23, 2010

The New Health care Legislation – How Does It Impact Medical Delivery For You?
According to President Obama, health reform will make health care more affordable, make health insurers more accountable, expand health coverage to all Americans, and make the health system sustainable, stabilizing family budgets, the Federal budget, and the economy.

CDHC and VBID: Clash of the Titans or a Powerful New Hybrid for Improved Health Care?
Great opportunities might be missed as the CDHC and VBID movements tussle and trade barbs

Proskauer Delivers Answers to Critical Employer & Benefit Advisor Questions on Health Care Reform
Latest Move To Publish Go-To Resource Authored By Firm’s DC Task Force Leaders Helps Managers Make Well-Informed, Strategic Decisions

Plan Changes Met Favorably by City Employees
During these difficult economic times, governments are faced with making tough decisions on benefits coverage that affects their most valuable assets—employees

Participation High in Incentive Program
The city of Fort Smith, AR, under the guidance of Human Resources Director Richard Jones, M.A., strongly believes in a proactive approach to health care

Medical, Dental Tourism Entices Employees
When Blue Lake employees require major surgery, their medical destination could be at a Companion Global Healthcare network facility outside of the United States. The company added a medical travel plan in 2008, followed by a dental travel plan the next year

Personal Touch Speeds Adoption of HDHP
Each member of the human resources team at Garden Fresh Restaurant Corp., which operates under the Souplantation and Sweet Tomatoes banners, is a superstar for their outstanding efforts to roll out a new high-deductible health plan

Benefits Team Lowers Financial Stress
Aetna’s financial benefits team, headed by Carol Klusek, believes that employee wellness should encompass the fiscal as well as the physical

New Wellness Program Gets Employees Feeling Better About Health, Benefits
Just as Ardent Health Services employees make a difference in the lives of those they treat, the company is making a difference in its workers’ lives

Success Continues with Enhanced Benefits Coverage
Robert Ihrie has helped Lowes create a comprehensive wellness program that fosters a culture of health and demonstrates real-life results for Lowe’s employees and bottom-line success for the company

CDHC Proves Successful
Although John Young has been a catalyst for making consumer-directed health care the fastest-growing employee benefit strategy in the mid-market segment, he deflects much of the credit onto key broker partners.

Navigating Health Care Reform for Employers and Employees
Description of some of the major changes that the Health Care Reform Law will bring into effect over the next eight years.

How Brokers Can Capitalize on Technology to Become a Trusted Partner
How brokers can become more relevant in a time when HR Departments are looking for ways to cut costs

Agencies Release Regulations on Preventive Care under the Affordable Care Act
On July 19, 2010 the federal agencies responsible for implementing the Affordable Care Act published interim final regulations interpreting the Act's requirement that certain group health plans cover a specific list of preventive services with no cost sharing

Managing Retiree Health Care Costs
The continuously increasing cost of health care benefits has long challenged many organizations. However, several issues are now converging that make the ability to manage retiree health care costs both critically important and particularly daunting.

What Next? A Call for Real Reform of 'Health' and 'Care'
Now that the long-debated health care bill has been passed and signed into law, we must turn our attention to addressing underlying problems of health and care in America.

Status Quo in Health Care Is Not an Option: PwC Report
Health organizations face more than 60 major regulatory deadlines over the next 10 years to meet the timetable and goals of health reform

Benefitfocus Acquires Benefit Informatics, Inc. to Provide Analytics and Plan Modeling
“All Your Benefits. One Place.™” meets “All Your Data. One Place.”

Disparities Remain a Challenge in Health Care Says American College of Physicians


Shared Decision Making: Empowering Patients
Health Dialog’s Dr. David Wennberg Champions Informed Patient Choice

Guardian Launches Online Employee Benefits Resource Center
New Guardian Website Provides Tools and Information to Help Employers & Brokers Strategize About Employee Benefits. Resources Also Available for Employees to Help Simplify Decisions about Workplace Benefits

R.E. Moulton Launches Unlimited Specific Coverage Reimbursement Option


ConnectYourCare Enhances CDH Participant Portal
ConnectYourCare Enhances CDH Participant Portal with WebMD Health Management Resources and Engagement Services: Innovative Pairing of Consumer-Directed Healthcare Account Information with Health Management Services to Drive Healthcare Consumerism & Better Health Outcomes

Latest Agency Regulations Address the Affordable Care Act’s Rules for Group Health Plans


The Benefits of Digging Deeper
Using Data Mining to Improve Employee Health and Reduce Employer Costs

HM Insurance Group Offers Unlimited Lifetime Maximums For Stop Los


Thomson Reuters Report Focuses on Capping U.S. Health Care Expenditures, Cutting Costs
Report Focus on shifting from a culture of "Sick Care" to true "Health Care"

Health Care Reform: Grandfathered Health Plan Regulations
By Susan M. Nash, Amy M. Gordon, Jamie A. Weyeneth and Elizabeth A. Savard, McDermott Will & Emery, LLP

Trustmark Offers a Full Range of Critical Illness Insurance Benefits for Spouse and Dependents


Health Incentives Accomplish More: Immediate, Intermediate, Long-term Methods of Incentives Programs
By Michael G. Dermer President and CEO, IncentOne

Employees Don't See What They Are Missing Without Vision Benefits
By Wendy Marshall Assistant Vice President, Corporate Benefits Medstar Health Inc.

COBRA Continues to Change
By John Jenkins, President and CEO, Benaissance

Dental Health Linked to Overall Health
By David Guarrera, DDS Vice President MetLife Dental Product Management

Guardian Widens Availability of Critical Illness Plans
Recent Enhancements Make The Plan Accessible For More Employers And Employees

Prescription Drug Data Key to Lowering Health Costs
There's a cure for high health costs--and you might say that it comes in pill form

Service Experience More Important than Cost to Overall Employer Satisfaction with Health Carriers
Even as health care insurance premiums continue to skyrocket, the service experience has more impact than cost management on overall employer satisfaction with their primary health insurance carrier, according to the J.D. Power and Associates 2010 U.S. Employer Health Insurance Plan StudySM released June 29.

Medical and Vision Go Together Just Like PB&J
New WellPoint Survey asks Americans about Pairings that Enhance and Simplify their Lives

An Innovative Solution to Rising Healthcare Costs
By Mark S. Gauyna, Principal, Borislow Insurance

Survey Shows Most U.S. Workers Will Continue to Rely On Employer Provided Health Benefits
Five Key Insights Reveal How Employees and Their Dependents View Health Care

Aetna's Quarterly Earnings Exceed Expectations
Health insurer Aetna Inc. on July 17 said its second-quarter operating earnings would exceed the current analysts' average forecast of 68 cents per share.

McKesson Launches Personalized Population Health Service
New service draws data from multiple sources for personalized care, communications

Reducing Health Care Costs While Improving Employee Well Being
By: N. Stephen Ober, MD, MBA, Executive Vice President at Verisk Health

Firms Shift More Health Care Costs to Employees
By Jerry Geisel

Care Coaching Shown to Improve Patient Outcomes
Health plans with members suffering from both physical and behavioral health conditions can reduce their medical expenses

CVS Caremark Announces Plan To Remove Walgreens From PBM Pharmacy Network
CVS Caremark Corporation announced June 9 that it will terminate Walgreens' participation in its retail pharmacy networks effective 30 days from today, or as otherwise may be required by applicable law or contract requirements

Disability Insurance Services and Custom Benefit Plans Announce New Relationship
Disability Insurance Services and Custom Benefit Plans have entered into a new strategic relationship to aggressively promote disability insurance.

New Ingenix TrendView Helps Employers Manage Medical Costs
Employers face intense pressure to control their medical costs while offering competitive health benefits that will attract and retain the best talent

BLUECROSS BLUESHIELD LAUNCHES ONLINE CARE AS A CORNERSTONE FOR HEALTHCARE REFORM
BLUECROSS BLUESHIELD OF WESTERN NEW YORK/BLUESHIELD OF NORTHEASTERN NEW YORK LAUNCH ONLINE CARE AS A CORNERSTONE FOR HEALTH CARE REFORM: On-Demand Health Care Services Arrive In New York State Following Rapid 90-Day Deployment

Milliman Indicates Health Care Costs Increase $1,303 in 2010 for Family of Four
Milliman Inc., the global consulting and actuarial firm, announced that average total medical spending for its "typical American family of four" reached $18,074

Reform Changes Lead Employers to Rethink Retiree Prescription Benefits
Big changes may be ahead with the impending changes to the Retiree Drug Subsidy

Survey Shows Gains in CDHPs, Cost-Shifting, Emphasis On Wellness
McGraw Wentworth released the results of its 2010 Southeast Michigan Mid-Market Group Benefits Survey

National Health Options Creates First Private National Healthcare Assistance Program for Employers,
New “retail” coverage option includes free pharmacy discount car.

Lighthouse1 Partners with TSYS Healthcare
Lighthouse1 announced a partnership with TSYS Healthcare to provide an integrated end-to-end healthcare payment solution.

Ceridian Web Forum to Help Employers Sharpen Health Benefits Strategies
Minneapolis, May 19, 2010 - Ceridian Corporation, a leading provider of managed human resource, employee benefits administration, tax filing and payroll outsourcing solutions, announced today it will present a free educational Web forum to help employers better use their health benefits to control future health costs and compliance risks, improve productivity and drive growth.

Engaging Employees Vital to Health Care Strategy


Talk Not Cheap at Intel
Year-Round, Frank Discussions About Health Plans Spur Increased Use of Consumer Plans

HHS Cracks the Door on the Retiree Reinsurance Money Grab
The Department of Health and Human Services (HHS) has issued the first in what promises to be a decades-long series of regulations and other guidance on the new health reform law. The new guidance concerns the temporary $5 billion retiree healthcare reinsurance fund authorized by the health reform legislation.