Reimbursement

A new high-deductible insurance plan from UPMC Health Plan will reward members who become more involved in their healthcare decisions and exhibit healthy behaviors via participation in more than 100 approved activities.

Few seniors are familiar with the Medicare Star Quality Ratings for Medicare plans from the Centers for Medicare & Medicaid Services and even those who do know about them rarely use the information to help select their Medicare plan.

HealthAmerica and Preferred Primary Care Physicians have launched a new pilot program aimed at providing more coordinated and patient-centered primary care and improved communications among patients, physicians and care teams.

Alternative benefit models rely on cost-sharing approaches for seniors, while some MedPAC members urged benefits that encourage changing unhealthy behaviors.

Aetna and CVS/pharmacy announced last week a co-branded Medicare prescription drug plan available in 43 states and Washington, DC, in a deal that will leverage the retail base of more than 7,200 CVS and Long Drug stores across the country.

In a recent speech at the Hoover Institution, Representative Paul Ryan (R-WI) argued again that his proposal to reform Medicare, and now his tax credit proposal for replacing the Democratic health care law for those under-age 65, would guarantee to citizens "options like the ones members of Congress enjoy."

Consumer organizations may find opportunities to partner with health plans in the coming years as more health reform changes take affect in the coming years.

I recently had some physical therapy for a minor injury. Since the office forgot to charge my co-pay the first time I went in I received a so-called EOB from my insurance carrier, BlueCross BlueShield of Massachusetts. EOBs are a holdover from the mainframe era: arcane, inflexible reports that are hard to interpret.

The Measure Applications Partnership (MAP), a public-private partnership convened by the National Quality Forum, released two reports on Tuesday that pointed to specific opportunities for more coordinated approaches to making healthcare safer and enhancing clinical performance.

Reimbursement cuts and new payment models resulting from healthcare reform are the biggest challenges confronting U.S. hospitals, according to a new survey of hospital CEOs.