Health systems in other countries and pilot projects in the United States have demonstrated that effective primary patient care that is comprehensive and accessible has the potential to improve health outcomes and lower costs. Primary care does this by ensuring that patients receive effective care measures for prevention and for management of chronic illness, by coordinating the use of testing and specialist evaluation and treatment, and by providing a comprehensive array of medical services in one clinic or office. Avoidance of duplicative care, unnecessary hospitalizations, and emergency room visits results in reduced health care costs. However, the necessary infrastructure and human resources to provide comprehensive and effective primary care are generally not adequately reimbursed to practitioners by payers. For this reason, it is difficult for primary care practices to supply services that are recognized as effective.

June 9, 2009 Reported By: Josie Huang Governor John Baldacci plans to sign a bill tomorrow that's aimed at giving the state's DirigoChoice health insurance program much-needed financial stability. To pay for Dirigo, the state charges health insurers a fee each year, which invariably leads to fights over how much the fee should be. Dirigo supporters say the bill to keep the fee fixed from year to year will avoid the expensive legal battles and bad blood. "The Number one thing that it does is it makes the funding source predictable and stable," says David Farmer, spokesman for the governor. Farmer tried to reassure the 9,000 people getting insurance through Dirigo, which is priced on ability to pay, and another 5,500 people who get Medicaid through the use of Dirigo dollars.

The Maine Senate has given final approval to a measure intended to put Maine's Dirigo Health Insurance program on a healthier financial footing.  The House approved the bill Friday, and Gov. John Baldacci, the bill's sponsor, is expected to sign it.

The bill provides an alternative to the Dirigo Health Program's current funding mechanism, a so-called "savings offset" fee assessed on insurers, which is based on how much health care savings the program generates.  Because the amount of savings is difficult to accurately nail down, the system has led to court battles.

Instead of relying on savings estimates, the new system will assess a fixed 2.14 percent fee on paid claims.  The Maine House passed the measure Friday by a vote of 83 to 53, and the Senate followed suit today by a vote to 20 to 15.

"The legislation directs Dirigo’s board of trustees to revamp the program to make it more affordable. The bill also replaces the savings offset payment with a monthly payment from insurance companies that equals 2.14 percent of their total claim payments. It’s estimated that would generate $42 million a year."

"Provides report cards and ratings on hospitals, physicians, health plans, nursing homes, home health agencies, hospice programs, and fertility clinics. Fees charged for many reports.--Last checked: 03/2004 ahml"

"AUGUSTA, Maine — Anthem Blue Cross and Blue Shield will not provide health coverage to Mainers through the state’s Dirigo Health Agency after this year because the two sides could not agree on terms to extend the contract. In a joint statement Wednesday, the two sides said they were unable to agree on acceptable financial terms to extend the contract for one year. Dirigo "is finalizing its plan to transition the program by Jan. 1, 2008, to assure that current members continue to have access to the DirigoChoice product and its subsidies," the statement said. About 15,000 subscribers are enrolled in the DirigoChoice insurance product that’s been administered by Anthem since 2003, two-thirds of them with individual coverage and a third in the group market, said Anthem spokesman Mark Ishkanian. What will happen to those subscribers when 2008 arrives was unclear Wednesday, Ishkanian said, because "we don’t know yet the direction the state’s going to go with the program." But he said Anthem is committed to helping the Dirigo agency make its transition. "We want DirigoChoice to succeed," Ishkanian said. "There are no hard feelings here." Anthem is also obligated to offer a similar insurance product to subscribers now covered under a DirigoChoice plan if they choose to remain with Anthem, but their premiums could go up, Ishkanian added. Dirigo Health was created by the Legislature in 2003 to curb health care costs, broaden access to coverage for thousands of Mainers who lack health insurance and promote health care quality. It is funded in part through savings in the health care system generated through the program. In July, Dirigo’s board of directors determined that the program will save $78 million in its third year of operation. The Maine Association of Health Plans, which represents state’s major health insurers, disputed the figure, saying the savings estimate is excessive. Maine’s major health insurers include Anthem, Aetna, Cigna HealthCare of Maine and Harvard Pilgrim Health Care. Wednesday’s statement by Anthem and Dirigo Health said the two organizations "have worked diligently to make this program a success and feel very good about what has been accomplished over the three years." "We are grateful that Anthem Blue Cross and Blue Shield stepped up three years ago to help make DirigoChoice a reality and that they will work with us closely to transition the program," the Dirigo board’s chairman, Robert McAfee, said in the statement. A message left with Dirigo Executive Director Karynlee Harrington was not immediately returned."

"to meet the needs of local government employees, retirees, dependents and employer groups by providing cost-effective, quality employee benefit programs and superior services. "

This is way misleading. During the first three month he was having chemo treatments. "He introduces us to a young man who's reached the end of three months of paid sick leave and is asked by his doctor if he's finally ready to return to work. No, not yet, he says. So the doctor gives him another three months of paid leave