Managed Care Report
Managed Care Report
• The Health Care Financing Administration (Baltimore) has approved Penn State Geisinger Health Plan’s Medicare HMO plan, Gold, for expansion into Dauphin, Lebanon, Lancaster, and Pike counties. There are an estimated 135,000 Medicare beneficiaries in the four counties, reported the Harrisburg Patriot. Six other health insurers already offer Medicare risk policies in the region, according to the Patriot. The new plan will become available in November.
• The National Committee for Quality Assurance (NCQA; Washington) last week released the names of an elite group of health plans from across the nation that have earned, by virtue of their commitment to clinical excellence, customer service, and continuous improvement, NCQA’s new Excellent Accreditation status. Nearly a dozen Blue Cross and Blue Shield plans were among the plans earning the top mark, NCQA said. Touchpoint Health Plan in Wisconsin also earned the new status, said NCQA. The organization also said 16 of the plans earning the excellent status are from New England. A full list of the recipients can be found on NCQA’s Web site at www.ncqa.org.
• Blue Cross and Blue Shield of Rhode Island (BCBSRI; Providence, RI) plans to change one of its key programs for elderly members, dropping free prescription benefits and increasing the premiums for a higher level of drug coverage. The change, reported the Providence Journal, will affect 30,000 Medicare recipients enrolled in BCBSRI’s HMO plan, BlueChip. The move is significant because BCBSRI has used free or low-cost drug programs to attract senior citizens to the HMO. And it’s another signal that overall health costs, which had been staedy for several years, are again on the rise, the Journal reported.
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