May 17, 2013

Today’s issue is brought to you by AIS's Health Plan Week, the industry's leading source of objective business, financial and regulatory news of the health insurance industry.

Insurers Increasingly See Year-One Market Changes as Time to Test Exchange Plans
Reprinted from Health Plan Week

Early signs from rate filings for 2014 — as in Maryland, where the dominant Blues plan recently asked state regulators for a 25% premium increase compared with 2013 policies for individual plans sold on the state-based marketplace opening next year — are indications of the uncertainties about how accurate pricing will be in the initial year of the public exchanges, health insurance industry insiders say, since other carriers asked for much more modest hikes .... Read Full Story

“I think any time you’re implementing something big [like the exchanges], there are going to be people who are nervous and anxious about ‘is it going to get done?’ until it’s actually done…. And there’ll be stories that can be written that say, ‘Oh, look, this thing’s — you know — not working the way it’s supposed to, and this happened and that happened.’ And that’s pretty much true of every government program that’s ever been set up.”

— President Obama, answering questions about the launch of exchanges at an April 30 press conference.

Click here to read the AIS's HEALTH REFORM WEEK article in which this quote appeared. (Free for HRW subscribers; $17 for non-subscribers).

Today's Datapoint

$74.4 billion … could be saved over the next decade in the upcoming expansion of Medicaid if states upgraded their pharmacy benefits management through the application of pharmacy best practices, according to a new study — Medicaid Pharmacy Savings Opportunities — funded by the Pharmaceutical Care Management Association.

Click here to read the DRUG BENEFIT NEWS article in which this datapoint appeared. (Free for DBN subscribers; $17 for non-subscribers).

• Congressional Record
• Federal Register

New York Medical College and The New York Eye and Ear Infirmary promoted Paul Sidoti, M.D., to chairman of the Department of Ophthalmology at NYEEI. Sidoti, who is also professor of ophthalmology at New York Medical College, had been NYEEI ophthalmology residency program director for the past seven years....St. John Providence Health System named Jean Meyer interim president and CEO. Meyer was president of hospital operations and executive vice president of St. John Providence.

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