Neb. insurer launches pilot program to cut costs, improve health; W.Va. Medicaid official defends no-bid contract

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Oct 1 2010

Lincoln Journal Star: Blue Cross and Blue Shield of Nebraska, the state's largest health insurer, is establishing a new pilot program that seeks to give doctors better patient information so that they can deal more effectively with patients' needs and help lower costs. The pilot will use a web-based program that officials hope can take disparate medical records and produce "tailored patient checklists" that doctors can use. "The program will start with about 1,200 diabetic patients in nine Nebraska cities, including Lincoln. Blue Cross and Blue Shield of Nebraska hopes to expand the approach quickly, moving toward a system that rewards doctors for making patients healthier rather than paying per procedure. … The pilot program dovetails with the patient-centered medical home concept" (Andersen, 9/29).

The Virginian-Pilot: "An independent hospital in Charlottesville announced today its intent to merge with Norfolk-based Sentara Healthcare. Martha Jefferson Hospital is a 176-bed nonprofit hospital that was founded in 1903. According to a release on its website, the Charlottesville hospital decided to merge with Sentara to keep up-to-date with technology and integrated information systems. The statement said those qualities will put the hospital in a better position to address health-care reform efforts. This is the latest in a string of mergers with smaller, independent hospitals that Sentara has been involved with during the past few years" (Simpson, 9/29).

KLTV (Tyler, Tex.): "A Tyler hospital is part of a group of hospitals suing the Department of Health and Human Services. Texas Spine and Joint is physician-owned, and section 6001 of the healthcare law prohibits expansion of those kind of hospitals unless they have permission from HHS. Wednesday, in federal court, attorneys representing the HHS secretary say that provision was put in place because doctors will refer patients to those hospitals. But, the plaintiffs, including Texas Spine and Joint, and more than 100 other hospitals, say these hospitals are providing excellent care, and should be allowed to expand" (9/29).

Charleston Daily Mail: "The head of West Virginia's Medicaid program defended a decision by state officials to enter into $600 million in no-bid contracts with three health insurance companies. Nancy Atkins, the commissioner for the state Bureau for Medical Services, said the contracts were not required to be bid out by the federal government. … Right now, the state has agreements with three health insurance companies to provide care to more than 160,000 Medicaid recipients who receive government-sponsored health insurance because they are on welfare" (9/30).

Courthouse News Service: "Louisiana wants to cut home-care Medicaid services for nearly 11,000 severely disabled poor people and institutionalize them, a class action claims in Federal Court. Louisiana faces a $1.6 billion budget deficit. Like many states, it is trying to slash spending, but similar class actions in other states have pointed out that institutionalizing disabled people will cost the states more in the long run. More than 80 percent of Louisiana's Medicaid money comes from the federal government, and if the state accepts the money, it must comply with federal rules, the class claims" (Canfield, 9/30).

Health News Florida: "Medicaid HMOs in much of Florida will receive average rate increases of almost 2 percent this week, after a numbers-crunching dispute between the industry and the state Agency for Health Care Administration. The rates will take effect Friday, a month after they were originally scheduled to be in place. Actual rate changes will vary widely in different parts of the state, with health plans in Miami-Dade County seeing decreases of more than 4.5 percent" (Saunders, 9/29).

This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.