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.

July 22, 2014

Today's Featured Story

Commonwealth Care Alliance Gets $10 Million Loan From New Fund to Aid Its Duals Growth
Reprinted from Medicare Advantage News

Commonwealth Care Alliance, which already has landed about 10,000 members in the new CMS-backed initiative for Medicare-Medicaid dual eligibles in Massachusetts, will get a $10 million loan from a new nonprofit investment fund to help meet state reserve requirements that will soar in light of this huge growth .... Read Full Story


From the AIS Blogs

Lawful Firing or Retaliation? VA Scandal Highlights Whistleblower Protection Laws

The scandal at the Department of Veterans Affairs (VA) that has so outraged the nation over veterans’ access to medical care also has pointed the spotlight on whistleblowers and a covered entity’s compliance with whistleblower protection laws ... Read more


Quote of the Day

“What we’ve been hearing about [at the Medical Group Management Assn.] is that health insurers have cut deals with the credit card companies to split the fees [on provider payments]. Not only are they saving money by not paying by check, they are actually making money off the provider’s payment. So as you can imagine that does not sit well with our members.”

— Robert Tennant, senior policy advisor at MGMA in Washington, D.C., told AIS’s Health Plan Week.

Click here to read the HEALTH PLAN WEEK article in which this quote appeared. (Free for HPW subscribers; $17 for non-subscribers).


Today's Datapoint

20 million ... people have gained health insurance coverage as a result of the ACA: 8 million via public exchanges and another 12 million through Medicaid expansion and by remaining on parental plans, among other methods, according to a new Commonwealth Fund study published in the July 2 New England Journal of Medicine.



FierceHealthPayer News from our partner FierceMarkets

Innovation meets insurance: 5 disruptive payers

It's no longer business as usual for health insurance companies in the post-healthcare reform market. Insurers now have to think outside of the box if they want to compete and thrive while vying for consumers' business ... Read more


Today from Washington

People on the Move

Cover Oregon named Aaron Patnode executive director. Patnode was director of business development at Kaiser Permanente Northwest….Silver State Health Insurance Exchange in Nevada appointed Bruce Gilbert executive director. He was a principal at Texas-based HIX Partners and former benefits administrator for Ohio. He replaces Jon Hager who resigned in February.


Content questions or suggestions should be directed to BJ Taylor, editor of AIS's HEALTH BUSINESS DAILY, 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)



AIS E-Savings Club Weekly Specials

Upcoming Webinars
Save $50!

Using Benchmarking Data to Set Out-of-Network Rates for ACOs, Narrow Networks and Exchange Products
Wed., July 23, 2014
Click here for details

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

Missed a Live Event?
Listen at your convenience to recent webinars with On-Demand or CD options!
Specialty Pharmacy Trends and Strategies: 2014
Medicare Advantage News
Get instant Medicare Advantage news!
Follow AISMedicare on Twitter
Follow AISHealth on LinkedIn
Like AISHealth on Facebook