Topic: Brain Food

Lighting the Path in the Golden Age of Government-Sponsored Health Programs: Join Us for the GHG Client Forum

John Gorman

More than 300 guests will convene on May 1-2 at the Red Rock Casino in Las Vegas for the 2014 Gorman Health Group Forum, our annual strategic retreat for leaders in government-sponsored health programs. This year’s gathering promises to be the most actionable, content-packed conference you could attend on how to succeed in this new Golden Age of government business. And when the learning and planning is done for the day, we will celebrate this unique moment in health care history as only GHG can in Vegas.  Here’s what’s happening this year and why you’ve got to join us: Read more

Leave a comment | Share | |

Innovation and Quality must go hand-in-hand

Regan Pennypacker

Plan sponsors are waiting with anticipation for their 2014 Medicare Star Ratings to be released. Just yesterday, Tufts Health Plan in Watertown, Massachusetts released the news that their Medicare Preferred HMO plan was awarded 4.5 out of a possible five stars. It reminds me of the old Ford commercial jingle where they said “Quality is Job 1″. No truer words apply when it comes to maintaining high quality plan options for our nation’s Medicare beneficiaries.

Read more

Leave a comment | Share | |

Sea Change at CMS

Jean LeMasurier

Administrator Marilyn Tavenner officially named Paul Spitalnic as the CMS chief actuary. I worked with Paul when he first came to CMS to implement the Part D program. He then served as the Director of the Part C and D actuarial group. Paul is very smart and will ably fill the shoes of other distinguished CMS chief actuaries that I have worked with including Guy King and Rick Foster.  Both Guy and Rick were outstanding public officials who came to CMS from the Social Security Administration and from a tradition of government run social insurance programs. I guess experience with the managed care side of Medicare is no longer considered a handicap.  To me this shows how much has changed at CMS. Part C is almost 30 percent of the Medicare program and Part D is administered through contracts with private plans.  These programs are no longer step children.  Congratulations Paul.

Leave a comment | Share | |

Health Insurance Premium Guessing Game

William MacBain

Health insurance issuers are generating enough fodder for a good guessing game. Will Obamacare increase rates for individual insurance or not? And if so, will the increase be modest or catastrophic. Writing in the April 25 edition of the Washington Post, Ezra Klein reports that the Blues plan that serves the national capital area is warning of big increases in individual premiums. The cause? More sick people are going to get health insurance, now that the pre-existing condition limitations have been removed by the Affordable Care Act. But is that the whole story? Klein also reports that insurance companies in Vermont and Rhode Island are projecting a more modest impact in announcing their proposed 2014 rates. But in Massachusetts, where “Obamneycare” has been in place since 2006, individual premiums are the highest in the nation.

Read more

Leave a comment | Share | |

The Path to a Deal on the Fiscal Cliff

John Gorman

Outside the Beltway Bubble it must look like we’re about to go all Thelma & Louise off the fiscal cliff.  In fact, each day the path to a deal becomes clearer, as brilliantly displayed by our friends at WaPo’s WonkBlog.  The one thing that is crystal-clear: the final deal will piss off everyone.

Read more

1 Comment | Share | |

Of course they should! (But not for the reason you may think)

Gorman Health Group

The New York Times reports that Hospitals fear they may bear the brunt of Medicare cuts.  I should hope so!  But not because they are wildly profitable at the expense of efficiency and innovation elsewhere.

Read more

Leave a comment | Share | |

An Old Friend’s Newest Challenge: Rein in Massachusetts’ Health Costs

John Gorman

An old, dear friend of mine and fellow XLHealth Board member, Stuart Altman, was just appointed chief of healthcare cost containment for Massachusetts’ ground-breaking reform effort — a harbinger of things to come nationally as the Affordable Care Act now hurtles toward implementation.  The local NPR affiliate did a great interview with Stu that I wanted to share here.  As always, Stu brings tremendous insight and a sense of history and trends to his work, and as goes Massachusetts, so will go the rest of the country in 2014 and beyond. Read more

Leave a comment | Share | |