health insurance plans

A maverick California cardiologist continues to expand his burgeoning hospital empire, which now stands to challenge some of the biggest chains in the state. While the rapid pace of his acquisition is drawing attention--he's acquired six hospitals during the past year alone--what's really got the industry buzzing is the fact he's canceling all of the hospitals' contracts with health insurance plans.

Dr. Prem Reddy's Prime Healthcare Services now owns eight hospitals in California, …

 Government takeover of healthcare not wise
It looks like Michael Moore has upset the health insurance industry. In an op-ed in USA Today, America's Health Insurance Plans head Karen Ignani contends his documentary Sicko has "grossly" distorted how health insurance plans work. If the United States was to follow Moore's recommendation for a complete government takeover of healthcare, she suggests, chaos would follow. Article

Medical centers specializing in cancer care say that health plans are denying coverage for routine care to patients who have enrolled in clinical trials. And now, they're backing a new bill which would make this practice illegal. According to Rep. Deborah Pryce (R-OH), who sponsored the measure, only 36,000 of 1.4 million Americans diagnosed with cancer each year agree to participate clinical trials--because, providers say, insurers will cut off payment for routine clinical services if …

> Physicians continue to voice opposition to the use of detailed data on their prescribing patterns in pharma drug marketing strategies. Article

> As part of his large health reform plans, Pennsylvania Governor Ed Rendell (D) has established a new commission intended to improve care for patients with diabetes and other chronic conditions. …

Legislators in the U.S. House of Representatives have begun considering a bill that would fund research comparing the effectiveness of standard treatments for common medical conditions. The bill would be financed not only from CMS revenues, but also insurers and employers. The research would then be performed by HHS's Agency for Healthcare Research and Quality. Drug makers and medical device companies will not be asked to fund the research; the assumption is that if they pay in, they …

How often do you see the insurance industry petition the government to set up another federal agency? Well, in this case, this most unlikely of events has actually occurred. America's Health Insurance Plans (AHIP), the association representing health insurers, has asked Congress to create an agency dedicated to comparing the effectiveness of existing medical treatments, drugs and devices with new ones. (It would be intriguing to see whether some doctors' instincts are correct that snazzy …

An consumer health advocacy group has concluded that despite having insurance, many Americans face medical costs they cannot afford. A new report by The Access Project suggests that deductibles and co-payments, as well as premiums, are a major source of medical debt for many consumers. Other contributors to medical debt included annual or lifetime benefit caps, out-of-network charges and patient confusion over what they owe. The report's overall conclusions square with another recent …

After a year of back-and-forth, a group of U.S. senators have reached a compromise on a bill offering "mental health parity" to health plan enrollees who have mental health coverage. While the details are still under discussion, generally speaking the bill would require health insurance plans with a mental health option to cover mental diseases the same way they do physical diseases, including reimbursement, co-payments, deductibles and limits on physician visits. The bill is being …

Consumers may not be thrilled with this approach, which might feel to them as though their freedom has been compromised. Still, it looks as if higher co-pays may steer them away from treatments researchers consider to be less useful. In a paper appearing this week in Health Affairs, Harvard University health policy professor Michael Chernew outlines a strategy by which insurance companies can save money--while improving care--if they raise co-pays for procedures or treatments that …

Two years after the odd couple of Sen. Hillary Rodham Clinton (D-NY) and former Republican House Speaker Newt Gingrich teamed up to tout electronic health records, more unusual groupings are forming in Washington. The Business Roundtable, representing major corporations, is getting together with organized labor--namely the Service Employees International Union--to launch "Divided We Fail," a campaign to push for broad-based-and unspecified-healthcare reform.

Tomorrow, America's …