Healthcare Roundup: Insurance Exchanges Questioned, Health Plans Criticized in Texas, Physician Leaders Learn Business, and More

Employer Group: Insurance Exchanges May Fail - The Council on Economic Development (CED), an influential group of 200 business leaders and university presidents, says that the Senate reform bill’s version of insurance exchanges may not work. While the CED supports the use of government-sponsored insurance markets to make coverage affordable for individuals and small businesses, it says that the Senate measure does not guard sufficiently against the possibility of adverse risk selection if insurers steer their sickest patients into the exchanges. The group recommends that the Senate adopt the more restrictive language of the House reform legislation in this area. [Source: UPI]

Insurance Industry Challenged in Texas - The Public Insurance Counsel of Texas, Deeia Beck, has asked the state’s insurance commissioner to prohibit clauses in health policies that give insurance companies the sole authority to determine whether or not a particular service is covered. Twenty-two other states already bar such provisions, and some of them provide for independent review of these coverage decisions. The insurance companies assert that if their contracts cannot include this kind of  clause, there will be more lawsuits against them and premiums will rise as a result. [Source: Dallas Morning News]

Physician Leaders Get Business Training - Historically, physicians who rise in the ranks of healthcare organizations have not had business training. That’s starting to change as the complexity of the regulatory and business environment increases. Some business schools are offering short, intensive courses to bring doctors up to speed. The physicians are applying this training to challenges such as improving care and efficiency and dealing with medical informatics projects. [Source: Wall Street Journal]

“Push” Technology for “Meaningful Use” - With physicians facing pressure to demonstrate “meaningful use” of their EHRs by 2011 to qualify for government incentives, there’s talk in health IT circles about using “push” technology to help physicians communicate with one another online. This is viewed as a faster way to get doctors exchanging data–a meaningful use criterion–than to require them to view data in disparate systems that are not connected in most areas of the country. [Source: Modern Healthcare]

Physicians Worry About Online Privacy - In a survey of 1,000 Massachusetts physicians, 86 percent said they believe that health information exchanges would improve the quality of care, and 70 percent said that HIEs would help cut costs. But 16 percent said they were still concerned about whether these exchanges would protect the privacy of patient records. A much smaller study of mental health professionals found that 63 percent of them are less willing to commit highly confidential information to an electronic record than to a paper chart. [Source: Healthcare IT News]