From the perspective of a health plan the people we serve are both members who are living their lives and patients interacting with the medical community, periodically or in the case of the chronically ill, constantly. This distinction between members and patients is often missed. Patients are the focus of most of the attention paid […]

The Massachusetts Legislature and the U.S. Congress are considering changes in the way health plans pay health care providers - in the commercial market (Massachusetts) and in Medicare (the federal government). Although details differ, the common element is that plans would pay an Accountable Care Organization (ACO) composed of hospitals, physicians, and related providers a […]

In a letter sent to president Obama in June, six major industry groups recommended health reform changes that could reduce administrative spending dramatically.  Among the recommendations submitted by health plans were administrative simplification measures that are relatively easy to accomplish and build on the work that plans and providers have been doing for years to […]