May 16, 2012

Today’s issue is brought to you by AIS’s Health Reform Week, the nation’s leading publication on the business implications of the massive changes for the health industry mandated by reform.

House Votes to Drain Prevention Fund to Pay for Student-Loan Relief
Reprinted from AIS’s Health Reform Week

The latest political skirmish on Capitol Hill has again put the health reform law’s prevention fund at risk, with the Republican-led House approving a bill April 26 that drains the $15 billion fund in order to pay for maintaining college-student loan interest rates at current levels .... Read Full Story

Requiem for an Earnings Reporting Season

For those of us crazy enough to listen to all the quarterly earnings calls of publicly held Medicare Advantage and Part D plan sponsors, there always are a few "rewards" in the form of especially quotable remarks of company executives ... Read more

“What we’re finding now is we sometimes have gaps in our pharmacy data [on adherence] because of retailer programs. I’m not picking on Walmart because we usually get most of their claims, but there are other chains that when they have their discount programs, we don’t actually get those claims into our system. What happens is it’s identified to us that [patients] are nonadherent, but they actually are compliant, so one of the struggles we’re having is to accurately reflect true adherence gaps.”

— James Hopsicker, vice president of pharmacy programs at MVP Health Care, told AIS’s Drug Benefit News.

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

Today's Datapoint

25% … fewer hospital readmissions for Medicare-Medicaid dual eligibles in Medicare Advantage resulted from SCAN Health Plan’s integrated care model, according to a recent study by Avalere Health.

From MEDICARE ADVANTAGE NEWS.

• Congressional Record
• Federal Register

The American College of Physician Executives appointed Lawrence Riddles, M.D., president and chairman of the board. Riddles recently retired as command surgeon with the Dept. of Defense's United States Transportation Command....MagForce AG, a medical technology company, named Christian von Volkmann head of finance. He has more than 14 years of international experience in corporate finance/capital market transactions, group structuring and mergers and acquisitions.

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