WellPoint Dips Toe Into Advising Providers On Managed Care

Other Medicare issues are examined: Observation care and cost to Medicare beneficiaries, hospice care and an experiment to give curative and palliative care at the same time.

The Wall Street Journal: WellPoint Advises Health Care Providers
WellPoint Inc. is pushing into the business of advising health care providers, with a deal between the insurer's CareMore unit and Emory Healthcare to jointly manage Medicare patients. CareMore will collaborate with Emory to revamp the care of the Atlanta nonprofit's private-plan Medicare patients, including people who will be covered by WellPoint's Blue Cross & Blue Shield of Georgia and also rival health plans. CareMore executives will help run the new joint operation, and Emory doctors and other health-care providers will implement a version of CareMore's clinical model (Mathews, 3/18).

The New York Times: When A Hospital Is Not A Stay
If you go to the emergency room and end up staying in the hospital, you may assume that you have been officially admitted. But it turns out that even though you are receiving treatment in a hospital bed, you may simply be under observation, and technically are still an outpatient. That can cost you money if you are covered under Medicare, the federal health plan for older Americans (Carrns, 3/18). 

Politico Pro: Medicare To Test New Approach To Hospice Care
Medicare will test a program to allow terminally ill people to get hospice and more aggressive care at the same time, a model long championed by advocates for better end-of-life care. Currently, people on Medicare can get hospice care if they have a life expectancy of six months or less, but many end up in hospice for only a few days, if that. The “either/or” approach -- hospice or aggressive care -- is widely seen as a barrier to hospice use. The new program will test the idea that “concurrent care” can expand patients’ choices, giving them the option of both palliative care and intense treatment without costing more (Kenen, 3/18).

Modern Healthcare: CMS Will Try Offering Hospice Patients Both Palliative, Curative Treatments
The CMS is moving forward with an experiment called for under the 2010 health reform law that will allow Medicare's hospice beneficiaries to get treatments aimed at helping them get better at the same time they get palliative care to help them die as comfortably as possible (Zigmond, 3/18).

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