Global study finds newborns struggle to survive

Fewer newborn babies are dying worldwide, but progress is too slow and Africa is being left behind, said a global study led by the World Health Organisation (WHO).

While investment over the last decade in health care for women and children has paid off in rapid declines in maternal death rates and deaths of children under five, improvement in the survival of babies in their first four weeks of life has been slower.

"Newborn survival is being left behind despite well-documented, cost-effective solutions to prevent these deaths," said Flavia Bustreo, a WHO expert in family, women's and children's health who worked on the study.

According to the findings, newborn deaths decreased overall from 4.6 million in 1990 to 3.3 million in 2009, but began falling slightly faster from 2000 to 2009.

Deaths of babies in their first four weeks of life now account for 41 percent of all child deaths before the age of five, a share which has grown from 37 percent in 1990 and is likely to increase further, the researchers said.

Yet the three leading causes of newborn death -- preterm delivery, asphyxia and severe infections -- are all relatively easily preventable with proper care.

Joy Lawn, of the charity Save The Children, who also worked on the study, said a critical global shortage of trained healthcare workers was a major contributing factor.

"We know that solutions as simple as keeping newborns warm, clean and properly breastfed can keep them alive, but many countries are in desperate need of more and better trained frontline health workers to teach these basic lifesaving practices," she said. "Training more midwives and more community health workers will allow many more lives to be saved."

Article Source: http://af.reuters.com/article/topNews/idAFJOE77U02T20110831

HealthPlan Holdings Appoints Michael Hudson as CFO

HealthPlan Holdings, Inc., a leading provider of outsourced solutions to insurers in the individual, union trust and voluntary benefits markets, has appointed Michael Hudson as CFO and executive vice president. In this role, he will manage the financial and accounting functions for the company's businesses.

"With a strong background in finance and healthcare, Mike has the experience needed to align our corporate strategy through appropriate financial accounting and forecasting," said Jeff Bak, president and CEO, HealthPlan. "We are pleased to welcome him to the team and look forward to the many contributions he will bring."

Prior to joining HealthPlan, Hudson served as the head of care management operations for Aetna, where he was responsible for overall regional strategy, partnerships with healthcare providers, network fortification and medical management. Additionally, he had a significant role in targeted growth market initiatives, state government and community relations and regional communications. Previous positions include president of Aetna's Northeast Region Healthcare Management and CFO for Aetna's small- and middle-market business.

Prior to joining Aetna, Hudson held a variety of finance and healthcare positions, including COO for CIGNA Medical Group and consulting actuary for Towers Perrin and Ernst & Young. Hudson, who is a Fellow of the Society of Actuaries, is completing his Master of Business Administration at Yale University. He earned his bachelor's degree from Lipscomb University in Nashville, Tenn.

About HealthPlan Holdings, Inc.

Founded in 2001, the origins of HealthPlan Holdings, Inc. date back to 1970. Today it provides end-to-end sales, administration and technology solutions to fully insured health plans, self insured employer groups, insurance companies and unions. The company supports more than 30 insurance carriers that utilize its technology and service solutions to help grow and retain their members, and reduce their membership administrative costs in the individual and small business markets. The company currently supports more than 2 million members and thousands of small businesses, as well as some of the nation's largest Taft-Hartley funds for unionized workers. Headquartered in Tampa, Fla., HealthPlan employs approximately 2,200 associates. For more information, visit www.healthplanholdings.com.

About Water Street

Water Street Healthcare Partners is a strategic private equity firm focused exclusively on healthcare. The firm has a strong record of building market-leading companies across key growth sectors in healthcare. It has partnered with some of the world's leading healthcare companies on its investments including: Johnson & Johnson, Medtronic and Smith & Nephew. Water Street's team is comprised of industry executives and private equity professionals with decades of experience investing in and operating global healthcare businesses. The firm is headquartered in Chicago. For more information about Water Street, visit www.wshp.com.

Article Source: http://www.sacbee.com/2011/08/29/3869377/healthplan-holdings-appoints-michael.html

Most US employers to keep health plans: survey

Almost three-quarters of medium to big companies will keep offering healthcare benefits to employees once state-based insurance exchanges kick off in 2014, according to a survey by a prominent benefits consulting group.

The study adds to a growing body of research tracking the effect of President Barack Obama's healthcare overhaul on employers, where most working-age Americans get their health coverage.

Less than a third of the surveyed employers felt confident that the exchanges would offer a viable alternative to coverage sponsored by the company, according to the voluntary survey conducted in July by Towers Watson and released on Wednesday.

Only nine percent of U.S. mid- to large-sized companies plan to end their healthcare benefits after state-based insurance exchanges launch in 2014, and six percent may do so without fully compensating their employees.

Twenty percent are unsure what they will do, according to the survey.

The U.S. healthcare overhaul passed last year requires all states by 2014 to have insurance exchanges, open marketplaces of competing insurance plans. In the first few years, the exchanges will only be open to individuals and small businesses -- those with at most 50 or 100 employees.

For employers, the exchanges could offer a chance to do away with hefty healthcare benefits costs as individual employees get a new venue to receive presumably attractive coverage.

To prevent an exodus, the healthcare reform law includes penalties that would hit bigger employers that offer no coverage if their workers end up receiving federal premium tax credits.

"The penalty in pretty much all cases is going to be a lesser amount than what they'd have to pay to subsidize employees' premiums," said Sabrina Corlette, who studies exchanges as a research professor at the Georgetown Health Policy Institute.

"But you're going to find out that these kinds of decisions, they're not just pure dollars-and-cents decisions for employers."

The Towers Watson findings align with Congressional Budget Office estimates but contradict a controversial study from consulting firm McKinsey, which found at least 30 percent of employers are like to stop offering health insurance in 2014.

Various industries and sectors will react differently when the exchanges do roll out, depending on factors such as corporate culture, employee demographics or how much money they have on hand, said Ron Fontanetta, senior health care consulting leader at Towers Watson.

"The penalty in and of itself is not likely to drive the decision; it's a combination of looking at that and the alternatives that their employees will have available through the exchanges," he said.

Fontanetta said more employers are likely to eliminate their plans for retired employees than for active ones.

The survey found most companies were actively preparing for the rollout of the healthcare reform -- even though almost half said they were not confident it would happen in the planned timeline -- as well as planning for steadily rising healthcare costs.

As part of that preparation, Fontanetta said companies are increasingly looking at ways to encourage their workers to stay healthy.

In a big increase from the current 8 percent, 57 percent of employers said that in the coming years they would consider rewarding or penalizing workers based on health measures such as blood pressure or cholesterol.

The annual Towers Watson Health Care Trend Survey collected voluntary responses from 368 U.S. employers, or about 12 percent of those that received the questions.

Almost 40 percent of the respondents had more than 10,000 employees. A quarter were in the manufacturing industry and about a third were from the Midwest.

Article Source: http://www.healthnews.com/en/news/Most-US-employers-to-keep-health-planssurvey/0ZF7MlNav0ce51IszQzXQs/

Nursing homes scramble to cope with Medicare cuts

Like most nursing home executives, Steve Flatt had hoped for a gradual phasing in of any cuts to Medicare payments for short-term stays by patients that require therapy or care when they leave the hospital.

Instead, the skilled nursing sector was shocked late last month by an 11.1 percent average pay cut that goes into effect Oct. 1, along with other regulatory changes that the industry fears will raise costs and eat into profits.

“Going forward — with new projects — you have to just reassess the viability of each project based on the new rules and new rates,” said Flatt, president of Murfreesboro’s National HealthCare Corp.

Specific effects on Nashville-area nursing home operators vary depending on their patient mix. At National HealthCare, for instance, Medicare accounts for nearly 38 percent of the company’s skilled nursing revenues.

As a result of the changes, the company is reviewing plans for three nursing homes that it plans to build in Middle Tennessee starting next year to ensure that each fits within the new reality. Those three homes combined could create up to 500 jobs.

“We could be delayed, based on these changes, but eventually we still hope to be able to move forward with each of them,” Flatt said last week. The good news, he said, is that National HealthCare has “a solid financial position with virtually no debt — and while (this) presents a challenge, we will certainly overcome it.”

Overall, the rate reduction plus changes in group therapy and other areas should reduce payments to the skilled nursing sector by $79 billion over a decade and lead providers to cut spending by $6.75 billion in the year starting Oct. 1, estimates Avalere Health LLC, an advisory services firm whose clients include skilled nursing companies.

Rate cuts apply to short-term stays in nursing homes, which account for between 15 percent and 18 percent of residents at the facilities in Tennessee, according to the Tennessee Health Care Association, an industry trade group.

“It probably impacts capital more than anything, having money to do upgrades and those sorts of things,” said Jesse Samples, the group’s executive director.
More cuts on tap for TN facilities

In Tennessee, Medicaid covers 65 percent of nursing home residents. The most recent state budget includes a 4.25 percent rate cut for nursing facilities that could increase to an 8.5 percent reduction beginning in January if additional federal funding isn’t secured by then.

On the federal level, the 11.1 percent cut is intended to bring overall Medicare spending on skilled nursing care back in line with earlier anticipated costs.

Not long ago, federal officials had altered the way patients would be evaluated, creating more payment categories that included higher rates for higher-acuity patients, those who needed the most care. The changes were supposed to be revenue neutral to Medicare, but instead more patients than expected ended up in the higher-paying categories.

Now, Medicare is changing things again — reducing payment rates in targeted categories and tweaking other things (such as group therapy) to put more patients into the lower-paying categories and pair the level of care with costs more appropriately.

One spinoff effect might be to basically wipe out group therapy, since providers won’t get paid any more for additional people in a session as they had before, said Samples.

Companies might have to hire more therapists, which would raise costs, Flatt adds.

“They’re trying to go back to 2010 payment levels, but at the same time they’ve forced additional expenses,” he said.
More rate cuts possible in 2013

In addition to the pending rule changes, skilled nursing providers could face an additional 2 percent reduction in Medicare rates starting in 2013 if deficit-reduction talks in Congress implode and trigger failsafe spending cuts.

Other publicly traded Nashville-area providers affected in varying degrees by the latest reimbursement cuts include Advocat Inc. and Brookdale Senior Living.

Then, there are other private operators. At Tennessee Health Management Inc. of Parsons, Tenn., Medicare accounts for as much as half of the firm’s total revenues. It manages 30 nursing homes statewide.

“We’ll have to look at anything that we would consider nonessential costs and find a way to be more efficient,” said Mark Davis, chief operating officer of the employee-owned skilled nursing operator.

Tennessee Health will take a second look at nursing homes it had planned in Spring Hill and in Jackson, Tenn. “It will make it difficult on us to be able to continue that project,” Davis said.
Industry analysts expect deals

Despite the industry worries and a hit to revenues, National HealthCare should be able to weather the federal cuts, industry analysts say.

“The company has weathered other reimbursement cuts,” said analyst Rob Mains of Morgan Keegan & Co. “The overall strategy for nursing homes doesn’t really change that much. Even with those cuts, it’s still profitable to treat these patients.”

National Health Investors Inc., the Murfreesboro-based real estate investment trust, generates two-thirds of its revenues from skilled nursing facilities, with most of that coming from National HealthCare, its key tenant.

Justin Hutchens, NHI’s president and chief executive, expects National HealthCare’s earnings after the cuts to be enough to cover its lease payments to his company several times over. NHI, meanwhile, is in talks to buy two portfolios of buildings from a pair of not-for-profit clients that would be the most affected by the cuts.

Analyst Jerry Doctrow of Stifel Nicolaus expects the Medicare rate changes to increase opportunities for NHI to acquire additional skilled nursing facilities.

Article Source: http://www.tennessean.com/article/20110823/BUSINESS05/308230017/Nursing-homes-scramble-cope-Medicare-cuts

Health insurers post higher earnings

The biggest commercial health insurers in Massachusetts yesterday posted sharply higher second-quarter earnings, citing their efforts to rein in administrative spending and a slower rise in medical costs reflected in the contracts they’ve negotiated with hospitals and doctors.

Blue Cross Blue Shield of Massachusetts, the state’s largest health insurance company, recorded net income of $56.5 million for the three months ending June 30, a reversal from the $14.3 million loss Blue Cross reported for the corresponding period last year.

Quarterly net income climbed to $13.5 million at Harvard Pilgrim Health Care, the second-largest health plan, from $6.5 million a year earlier.

Tufts Health Plan, meanwhile, registered second-quarter net income of $35.9 million, an increase from $11.5 million a year ago. And Fallon Community Health Plan reported income of $13.6 million, compared with a $12.8 million loss during the same quarter in 2010.

Investment income represented a large chunk of health insurers’ gains in the April-to-June period, which preceded the past month’s turbulence in financial markets.

Income from the sale of stocks, Treasury bonds, and other assets accounted for $30.2 million of the earnings of Boston-based Blue Cross in the second quarter. Tufts, based in Watertown, posted quarterly investment income of $11 million, while Wellesley-based Harvard Pilgrim recorded investment income of $6.3 million. Fallon, based in Worcester, reported $5.2 million in investment income during the three-month period.

But operating income also improved for the insurers, as moderating price increases for medical care translated into reduced insurance payments - and less onerous premium hikes for businesses and individuals. That trend should continue into the second half of the year based on figures reported last week by the state Division of Insurance.

Insurance regulators approved average base rate increases of 5.9 percent for Blue Cross and Tufts, 3 percent for Harvard Pilgrim, 5.9 percent for its health maintenance organization, 5.3 percent for Fallon, and 5.4 percent for its HMO. The average base rates were on policies renewing in the fourth quarter for small businesses and individuals.

The average base rate increases don’t include additional factors, such as the type of business and age of the workforce, that apply to many insurance customers. Over the past several years, the average base rate increases often exceeded 10 percent.

“We’re expecting the cost trend, which has moderated, to continue at the level it’s at,’’ said Allen P. Maltz, executive vice president and chief financial officer of Blue Cross. “Rate increases have come down for customers, and we’re hoping they’ll stay in this range.’’

Affordability has become an important goal for health insurers and providers, with state government and business officials complaining that the cost of medical care has crippled their ability to create jobs. The health plans have sought to make their reimbursements more predictable by launching so-called global payment plans that give doctors and hospitals annual budgets to care for patients rather than reimbursing them for every visit and procedure.

Blue Cross’s global payment plan, called the “alternative quality contract,’’ now accounts for roughly a quarter of its overall business, Maltz said. Other health insurers have initiated similar plans while also moving toward limited or tiered network policies that reward customers with lower premiums in return for restricting the pool of providers they use.

Insurers have been trying to steer patients toward lower-cost health care without hurting the quality of care. Another factor working in their favor has been a decline in health care spending, as many cost-conscious patients postpone doctor visits or delay elective procedures such as knee replacements.

“Unfortunately, the economic news of the last week is likely to prolong this trend,’’ said James W. DuCharme, chief financial officer for Harvard Pilgrim. “We don’t believe this will continue forever. Eventually, the use of medical care that has been delayed will reemerge.’’

One major challenge for the health plans will be negotiating new contracts with hospitals and physicians that build on a continued moderation of price increases. The providers are also facing reimbursement cuts from their public payers for Medicare and Medicaid, the government health insurance programs for senior citizens and low-income residents.

Blue Cross, for instance, said it is currently negotiating new contracts with about a third of its provider network. That includes Partners Healthcare System Inc., the Boston-based parent of Massachusetts General and Brigham and Women’s hospitals, which has agreed to reopen early contracts that don’t expire until 2012. If the talks are successful, it would effectively lower health care prices already agreed to next year at Partners hospitals.

Article Source: http://www.boston.com/business/healthcare/articles/2011/08/16/health_insurers_post_strong_quarterly_earnings/

United States Postal Service considering breaking union agreement, cutting 120K jobs: report

The U.S. Postal Service is considering a plan to break union agreements and slash 120,000 or more jobs by 2015 to make up for billions of dollars in losses, according to published reports.

The financially strapped agency is also considering yanking postal workers out of the retirement and health benefit plan that covers federal workers - and setting up their own, much cheaper, benefit system.

Postal officials warned in draft documents obtained by the Washington Post that if they don't take these drastic steps the agency could go bankrupt.

Cutting workers is "key to securing our future," the documents state.

Congress would have to approve either move, and both will surely face stiff resistance from postal unions.

"We will resist this blatant attempt to subvert and circumvent collective bargaining," said Fredric Rolando, head of the National Association of Letter Carriers.

Art Sackler, whose Coalition for a 21st Century Postal Service represents corporate mail customers, said something has to be done to stop the bleeding.

"Desperate times may require desperate measures," Sackler told Bloomberg News. "We are heartened to see the Postal Service is determined to confront its financial crisis aggressively."

Currently, the Postal Service employs 583,908 full-time workers. But the agency has shed more than 100,000 jobs in the last four years.

Loss of business due to inroads by the Internet and automation - coupled with a severe downturn in advertising caused by the recession - are among the reasons why the Postal Service is in the red.

Postal officials, who reported losses of $8 billion last year, have floated other ideas to improve its bottom line, including scrapping Saturday service.

Last month, officials released a list of 3,700 locations it was thinking of closing, including 34 in New York City.

The Post Office does not receive taxpayer dollars and is funded entirely by its own revenue. But in recent years it has borrowed heavily from the U.S. Treasury to stay afloat.

Article Resource: http://www.nydailynews.com/news/national/2011/08/12/2011-08-12_united_states_postal_service_considering_breaking_union_agreement_cutting_120k_j.html

Ex-HMO attorney named head regulator of California health plans

A former attorney for one of the nation’s largest HMOs has been picked to run the California agency that oversees health plans.

Brent Barnhart, 68, was named by Gov. Jerry Brown this week to lead the California Department of Managed Health Care, which regulates HMO health coverage for more than 21 million Californians.

Barnhart spent 13 years as senior counsel for the Oakland-based Kaiser Foundation Health Plan. The nonprofit provides healthcare to more than 8.8 million people in eight states and Washington, D.C.

Barnhart came out of retirement to take the job, becoming just the third director of the managed healthcare department since it was created more than a decade ago.

The Danville resident said he couldn’t resist the opportunity to lead a consumer protection agency, particularly with national healthcare reform swiftly changing how health plans and providers deliver healthcare.

“This is a career capper for me,” Barnhart said. “This is like being released to do what I want -– to make things work.”

Prior to his work at Kaiser, Barnhart spent three years as a policy consultant to the state Assembly and was legislative affairs director for Blue Cross of California in the early 1990s. He also worked at the Association of California Life and Health Insurance Companies, a trade group, and at the American Civil Liberties Union.

Barnhart must still be confirmed by the state Senate. His annual salary will be $142,965.

Brown made two other healthcare-related appointments this week, neither of which requires Senate confirmation.

The governor named Shelley Rouillard, 55, as chief deputy director of the managed healthcare department. The Sacramento resident came from the state’s Managed Risk Medical Insurance Board, where she was deputy director of the benefits and quality monitoring division. She will earn $125,000.

John Shen, 61, has been appointed chief of the long-term care division at the state Department of Health Care Services. In his last job, Shen was executive director of the Marin Community Clinic. The Berkeley resident will earn $122,196 a year.\

Article Source: http://latimesblogs.latimes.com/money_co/2011/08/brent-barnhart-california-healthcare-regulator.html