Two risk retention groups have joined forces with a healthcare research group to create a new course of study for risk management in senior care, a specialty that did not exist before.

Published in The Risk Retention Reporter, December 2010. Click here to download the article.

Vermont’s Captive Insurance Division is planning new regulations that would make it the first state to adopt the National Association of Insurance Commissioners’ (NAIC) model risk retention group guidelines for reinsurance. The division regulates about 30% of the nation’s active RRGs...

This article was published in The Risk Retention Reporter in September 2010. Copies are available to prospective clients on request.

As healthcare costs continue to climb and the slow U.S. economy pushes more people into medical assistance programs, states are increasing their use of care management strategies to help rein in costly Medicaid programs. A new analysis by Mark Farrah Associates (MFA), a leading data aggregator and publisher of health plan market data, confirms U.S. enrollment in managed Medicaid plans is on the rise. Total membership grew by 9.7% from June 2008 to September 2009, reaching more than 23 million.

The growth rate in Medicaid managed care plans is even stronger than the increase in total Medicaid enrollment, estimated recently at 7.5% from mid-2008 to mid-2009. Both statistics demonstrate a growing opportunity for health plans seeking to replace business lost in employer groups.

This Healthcare Business Strategy brief presents preliminary results of MFA’s Medicaid segment analysis project and discusses how states and health plans are approaching this market.

Click here to read the brief.

Amidst the turmoil of healthcare reform, fortunately the quest for real solutions to control rising healthcare costs is still alive. Several industry leaders are gaining support for reviving an innovative model called the Patient-Centered Medical Home (PCMH) that dates back to the 1960s. On the surface, the model appears to resemble the health maintenance organization (HMO) and is based on similar principles of coordinated care. On closer examination, it is clear that the PCMH is far less restrictive than traditional HMOs and could very well emerge to play a key role in the next generation of healthcare.

This email and online newsletter was published by Mark Farrah Associates on October 16, 2009.

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September promises to be a busy month for health insurance executives as they respond to requests for data and prepare testimony for a number of congressional committees working on healthcare reform.

WASHINGTON, D.C. — The question of the day at the 14th annual Wall Street Comes to Washington conference July 8 was: “What effect will healthcare reform legislation have on the market for health insurance, and how will hospitals and providers figure into the picture?” The answer, of course: “The devil is in the details.” Although some broad parameters of the legislation are taking shape, no one yet knows what the details will be.

The conference, sponsored by the Center for Studying Health System Change (HSC) and funded by the Robert Wood Johnson Foundation, pairs Wall Street analysts covering the healthcare industry with policy experts from Washington think tanks. The idea, according to HSC President Paul Ginsburg, is to have equity and bond analysts “bring their understanding of market forces to bear on questions that those involved in health policy have on their minds.”

This year’s panelists are following every twist and turn of the debate in Congress over how to reform the nation’s broken healthcare system, which is costing too much of our economic resources (estimated at 16.7% of gross domestic product in 2008) and providing too few people with quality, insured care. Panelists expressed concern that the debate is focusing on inclusion of a “public plan option” in the legislation at the expense of looking for ways to stem increases in healthcare spending.

This article was published July 10 in Healthcare Business Strategy, an online and email newsletter published by Mark Farrah Associates.

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