AIS's Health Business Daily
Strategic Business News from Experienced Health Care Reporters
at Atlantic Information Services, Inc.
Medicare Advantage News
Today’s issue is brought to you by AIS's Medicare Advantage News, biweekly news and analysis on the Medicare (and Medicaid) managed care programs.

August 1, 2014

Today's Featured Story

Medicare Advantage Members in Focus Group Voice Gripes About Plans’ Customer-Service Policies
Reprinted from Medicare Advantage News

A focus group of seniors enrolled in Medicare Advantage plans this month turned up considerable dissatisfaction with both the information available for choosing MA plans and the customer service once they were in the plans. Members of the group also seemed to regard the relationship between their providers and the MA plans as almost adversarial and sided with their doctors, although a minority did cite some good experiences with their plans.... Read Full Story


From the AIS Blogs

Are Specialty Drug Tiers, Mandatory Mail Order Discriminating Against People on Basis of Disability?

Could a larger movement against specialty drugs placed on high formulary tiers be spurred by the actions of consumer advocacy groups in California and Florida against health plans and their coverage of HIV/AIDS drugs and requirements for members who take them? ... Read more


Quote of the Day

“Evidence documenting the effectiveness and tolerability of the newer sofosbuvir [Sovaldi] regimens [for treating hepatitis C], and the expected reductions in downstream costs associated with averted progression of disease, suggest that these newer expensive medications may represent a relatively good ‘deal’ by typical cost-effectiveness thresholds.”

— Chief medical and scientific officers for CVS Caremark Corp. suggested in a commentary in the Journal of the American Medical Association.



Today's Datapoint

3.5% ... was the rate of increase in medical care spending in the first three years of CareFirst BlueCross BlueShield’s patient-centered medical home program, after an average of 7.5% in the five years prior to 2011.

Click here to read the THE AIS REPORT ON BLUE CROSS AND BLUE SHIELD PLANS* article in which this datapoint appeared. (Free for THE AIS REPORT subscribers; $17 for non-subscribers).
* Not affiliated with the Blue Cross and Blue Shield Association or its member companies.


Today from Washington

People on the Move

Egalet Corp. appointed Jeffrey M. Dayno, M.D., chief medical officer, responsible for leading Egalet's clinical development programs as well as overseeing the activities in regulatory affairs, pharmacovigilance and medical affairs. He most recently served as vice president, global medical affairs, at ViroPharma....CareSource appointed Douglas A. Fecher to the board of trustees. Fecher is president and CEO of Wright-Patt Credit Union.


Content questions or suggestions should be directed to Executive Editor Jill Brown at If you are interested in sponsoring AIS's HEALTH BUSINESS DAILY, please contact Bailey Sterrett at

AIS's HEALTH BUSINESS DAILY is copyrighted and protected by federal law. The re-use of its content is restricted (see below). However, you are permitted to forward this e-mail to as many of your friends and colleagues as you wish, or better yet have them sign up for their own copy at atlantic_subscription.cfm, where you can also sign up for AIS's Government News of the Week and Spotlight on Health Insurers.

Copyright © 2014 Atlantic Information Services, Inc. (AIS). All rights reserved. It is not permissible to include all or any portion of this content on any Web site, intranet or electronic network or in any print publication, without AIS's written permission in advance. Permission requests should be directed to

With archives of AIS's Health Business Daily, features like the News Archives, AIS Blogs and more! (Free registration required)



The 6th Annual Insurer’s Customer Experience and Member Retention Summit, Sept 8-9 in Boston, MA.

Upcoming Webinars
Save $50!

Avoiding Costly Part D Sanctions: Rx Access Strategies for Plans and PBMs
Tues., Aug. 5, 2014
Click here for details

Private Exchange Strategies for Insurers: What’s Working? What’s Not?
Wed., Aug. 6, 2014
Click here for details

Health Plan/Employer Strategies for Implementing Narrow Pharmacy Networks
Tues., Aug. 12, 2014
Click here for details

Stark Law DOs and DON’Ts: Best Practices for Your Physician Contracts
Thurs., Sept. 18, 2014
Click here for details

Missed a Live Event?
Listen at your convenience to recent webinars with On-Demand or CD options!
Medicare Advantage News
AIS's Medicare and Medicaid Market Data: 2014 - Order Today!