Saving the system: Mickey Herbert views market-based system as America's way to go Sep 1, 2008 By: Julie Miller

As far back as 1971, Mickey Herbert has believed that a market-based system of healthcare delivery is the only option for America. Now president and CEO of ConnectiCare, a commercial and Medicare Advantage insurer, Herbert still believes in the market-based system.

Delivering information: AHRQ drives quality in context Aug 1, 2008 By: Julie Miller

To improve the quality, safety, efficiency and effectiveness of the healthcare system, the U.S. Agency for Healthcare Research and Quality (AHRQ) is tasked with a mission to gather research and disseminate valuable findings to those who can translate information into practice. Carolyn Clancy, MD, an internist with decades of experience in fact finding and analysis, directs the agency.

Purchasing value: The Pacific Business Group on Health champions nationwide innovation Jul 1, 2008 By: Mari Edlin

When Peter Lee stepped down in January from his eight-year tenure as president and CEO of the Pacific Business Group on Health (PBGH), he chose to stay close to home, taking over the new role of executive director of national health policy for this non-profit organization of large employers and other major purchasers. Although Lee wears a new hat, he is confident that he has left the CEO position in the hands of a competent and experienced healthcare thought leader: David Lansky. The duo has easily blended its expertise—Lansky as the information technology whiz and Lee as the national healthcare policy guru and patient advocate. Both share a passion for data and measurement.

Package pricing: Geisinger's new model holds the promise of aligning payment with optimal care Jun 1, 2008 By: Julie Miller

Geisinger Health System and Geisinger Health Plan have attracted attention from key industry players ever since introducing a bundled-pricing program called ProvenCare in 2006. Richard Gilfillan, MD, president and CEO of Geisinger Health Plan, played a critical role in the launch of the new payment structure.

Welcome Back: Network Health Plan tracking number of disenrolled members who return to plans May 1, 2008 By: Julie Miller

Higher-than-expected enrollment has challenged the budget and the administration of public health coverage in Massachusetts ever since its universal health plan took effect in April 2006. Christina Severin, executive director of Network Health in Medford, Mass., a private plan that covers subsidized Commonwealth Care members as well as MassHealth Medicaid members, believes programs will continue to struggle until one particular problem is solved: enrollment churning.

Beware of barriers to care: Pitney Bowes increases access to care through on-site clinics and low-cost drug benefits Apr 1, 2008 By: Julie Miller

Employers are finding themselves between a rock and hard place when it comes to health benefits. If they reduce or eliminate benefits, they lose quality workers as well as productivity. If they maintain or increase benefits, they're almost certain to spend beyond their budgets year after year. In trying to strike a happy medium, more employers are now remodeling their health benefit plans dramatically, hoping to see better results.

Basic facts: Kaiser Family Foundation puts healthcare facts and figures at the fingertips of policy makers, MCOs, and the public Mar 1, 2008 By: Julie Miller

If you had $40 million to spend each year on a philanthropic mission in healthcare, what would your mission be? Helping the uninsured? Bankrolling demonstration projects? To deliver the greatest impact within the $2 trillion U.S. healthcare system, you would have to be choosy about your commitments.

Doctor driven: Physicians weigh tough decisions in CDPHP board rooms Feb 1, 2008 By: Julie Miller

Physicians' first-hand experience has no substitute, and Dr. William Cromie has maintained CDPHP's vision of including physicians in the governance of this health plan. Often, the plan and the physicians are faced with tough choices and collective compromises.

An important component of the legislation that has not received a lot of press to date has been the Health Care and Quality Cost Council (HCQCC) which was established by the same health reform law that created the Connector.