Managed Care News and Research

RSS

New text messaging program to manage diabetes

D.C. Chartered Health Plan, Inc., the oldest Medicaid managed care organization in the District of Columbia, is launching a new text messaging program for 50 of its members to help them better manage diabetes, which requires regular care to avoid costly complications.

9 Apr 2012

UNC implements Lawson Human Capital Management solution

Until December, 2011, UNC Health Care System relied upon a legacy Human Resources system that was not designed for the healthcare industry. And this mismatch created problems that necessitated awkward, albeit creative, workarounds. But now, thanks to CIBER partnering with UNC to implement the Lawson Human Capital Management (HCM) solution, they are responsive and agile, especially in terms of reporting and employee issues.

7 Apr 2012

ODJFS selects Aetna to administer services in Ohio

Aetna Better Health of Ohio, an Aetna health plan that administers benefits for Medicaid members, has been selected by the Ohio Department of Job and Family Services (ODJFS) to administer services in Ohio. The contract will be effective January 1, 2013.

7 Apr 2012

Medicaid news: Oregon competitors working together; Calif. 'duals' project launches

A new push to reshape health care in greater Portland is reminiscent, its biggest booster says, of the race to land a man on the moon. Erstwhile health care competitors hope to set aside their differences to care for the region's 200,000 Oregon Health Plan members, says Legacy Health CEO George Brown. The task is happening in a timeline -- Brown snaps his fingers -- "that's like that long. It's a moon shot for sure. What we're trying to do, to my knowledge, has not been attempted any place in the country."

6 Apr 2012

Understanding how key decision makers assess prescription drugs for health plan coverage

As medical advancements and an expanding pharmaceutical industry bring new prescription drugs into the market, deciding which ones to cover is becoming an even more difficult choice for health plans to make. How those decisions are made - and what information is used in the process - was the focus of a recent study by researchers at RTI International.

5 Apr 2012

Health plan settles lawsuits in Fla.; Minnesota HMOs to return $73M to state, feds

In Florida, a health plan in Tampa will pay $137.5 million to settle lawsuits over Medicare and Medicaid claims, while Magic Johnson plans to invest in a new HIV plan there. In Minnesota, the federal government and the state will split $73 million nonprofit HMOs are returning while other Minnesota health plans profits jump 21 percent.

5 Apr 2012

State roundup: Feds deny Hawaii Medicaid hospital limit; Ariz. prison health care gets operator; States consider ins and outs of health law implementation

The Obama administration has rejected Hawaii's proposal to limit most adult Medicaid recipients to 10 days of hospital coverage per year, which would have been the strictest in the nation. Instead, Hawaii has been approved to implement a 30-day hospital coverage limit starting July 1, state and federal health officials say.

5 Apr 2012

CompCare's 2011 revenues increase to $71,210,000

Comprehensive Care Corporation, a leading behavioral health, substance abuse and psychotropic pharmacy management services provider for managed care companies throughout the U.S., is pleased to announce that its revenues for 2011 more than doubled to $71,210,000 compared to revenues of $35,214,000 in 2010.

2 Apr 2012

Insurers, employers react to idea of a health law without an individual mandate

Insurers' "worst nightmare" is that the Supreme Court would overturn the health law's insurance requirement but leave the rest of the overhaul intact. Employers are being advised to continue working toward meeting the law's deadlines.

31 Mar 2012

HHS Secretary announces six winners in HHSinnovates program

Health and Human Services (HHS) Secretary Kathleen Sebelius announced six winners in the HHSinnovates program today in a ceremony at HHS headquarters, saying all the entries "show a vibrant culture of innovation" within the department.

31 Mar 2012

Calif. readies Medicaid changes for dual-eligibles, adult day care program; Other Medicaid news from the states

California is revamping its adult day health care program as well as its program for people who are eligible for both Medicare and Medicaid. In Florida, a judge orders the Medicaid program there to cover autism therapy, and Georgia prepares to restructure its program.

30 Mar 2012

State experiences with insurance mandates offer cautionary tales

In Massachusetts, reforms are proceeding with an individual mandate, while Washington state and New Jersey faced hardships when they overhauled their health insurance markets without one.

29 Mar 2012

N.Y. seeking Medicaid waiver; Calif. adult services lawsuit now 'unsettled'

New York plans to overhaul the nation's most expensive Medicaid health care system to save $18.3 billion over five years, and will ask the federal government for half of those savings.

27 Mar 2012

State highlights: Mass. enforcing individual mandate; Improving kids' dental coverage; Health 'navigators'

Getting the word out is half the battle, and the state is well into a $3 million media campaign ... [E]very adult must have insurance by December. If they don't and if the state determines that insurance was affordable for them, they will be fined $219 next year. The penalty increases substantially in 2009.

23 Mar 2012

Kansas Senate considers how to oversee Medicaid managed care plans

Gov. Sam Brownback's plan to move recipients into managed care has drawn controversy, even from fellow Republicans.

22 Mar 2012

Health law oral arguments: Analyzing the moving parts

News reports explore the constitutional questions to be explored in the high court's review of the health law and the most likely potential outcomes.

21 Mar 2012

Roundup: States face new revenue downturn; Calif. county has disparities in life expectancy

Revenues in most U.S. states increased in the fourth quarter of 2011, but their recent surge is tapering off, as they grew just 2.7 percent from the final quarter of 2010, according to a report released on Monday. "This is a noticeable slowdown from the 11.1 (percent) and 6.1 percent year-over-year growth reported in the second and third quarters of 2011, respectively," the Rockefeller Institute, a think tank that closely watches states' revenues, said in the report.

21 Mar 2012

UnitedHealth selected as Managed Care Support contractor for 2.9M TRICARE beneficiaries

UnitedHealthcare, a UnitedHealth Group company, said its Military & Veterans Services business unit has been awarded the Department of Defense's TRICARE Managed Care Support contract to provide health care services for active duty and retired military service members and their families in the West Region.

19 Mar 2012

TriZetto QNXT Essentials solution to streamline administration of Ventura County's HMO

Ventura County, Calif., has selected The TriZetto Group, Inc., to help improve the administrative efficiency, care delivery, and provider and member service of the county's health plan. TriZetto's end-to-end solution will streamline the administration of Ventura County's HMO, which serves employees and their families, retirees, Medicare recipients, and county-affiliated organizations.

19 Mar 2012

$Ponatinib to earn gold-standard status for refractory chronic myeloid leukemia in 2015$

Ponatinib to earn gold-standard status for refractory chronic myeloid leukemia in 2015

Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that surveyed U.S. hematologist-oncologists and managed care organization (MCO) pharmacy directors agree that survival effect is one of the attributes that most influences their decisions regarding prescribing and formulary status determinations, respectively, in patients with chronic myeloid leukemia who have failed first-line tyrosine kinase inhibitor therapy.

19 Mar 2012

Managed Care News and Research

New text messaging program to manage diabetes

UNC implements Lawson Human Capital Management solution

ODJFS selects Aetna to administer services in Ohio

Medicaid news: Oregon competitors working together; Calif. 'duals' project launches

Understanding how key decision makers assess prescription drugs for health plan coverage

Health plan settles lawsuits in Fla.; Minnesota HMOs to return $73M to state, feds

State roundup: Feds deny Hawaii Medicaid hospital limit; Ariz. prison health care gets operator; States consider ins and outs of health law implementation

CompCare's 2011 revenues increase to $71,210,000

Insurers, employers react to idea of a health law without an individual mandate

HHS Secretary announces six winners in HHSinnovates program

Calif. readies Medicaid changes for dual-eligibles, adult day care program; Other Medicaid news from the states

State experiences with insurance mandates offer cautionary tales

N.Y. seeking Medicaid waiver; Calif. adult services lawsuit now 'unsettled'

State highlights: Mass. enforcing individual mandate; Improving kids' dental coverage; Health 'navigators'

Kansas Senate considers how to oversee Medicaid managed care plans

Health law oral arguments: Analyzing the moving parts

Roundup: States face new revenue downturn; Calif. county has disparities in life expectancy

UnitedHealth selected as Managed Care Support contractor for 2.9M TRICARE beneficiaries

TriZetto QNXT Essentials solution to streamline administration of Ventura County's HMO

Ponatinib to earn gold-standard status for refractory chronic myeloid leukemia in 2015

Advancing Intracellular Delivery with LumiPore®

How ELRIG Is Helping Mid-Career Scientists Navigate Leadership, Career Change and Redundancy

The role of UV-Vis in biopharma QC

Latest News