Jan. 26, 2011

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.

Today's Featured Story

Medicare Advantage Plans Prepare for Medical Loss Ratio Regulations, Eye More Capitated Pacts With Providers
Reprinted from Medicare Advantage News

Although Medicare Advantage insurers will not have to comply with the medical loss ratio minimum and rebate provisions of the health reform law until 2014, there are several steps plans may take to meet the new requirements, such as adjusting provider contracts to embrace more capitated arrangements, reallocating expenses to reduce administrative costs and cutting broker commissions. But such strategies are likely to invite greater scrutiny from CMS, warned speakers at a recent panel discussion on MLR regulations for MA plans .... Read Full Story


Quote of the Day

“At some point, the ‘politics’ of the [end-of-life counseling] discussion will give way to the reality that appropriate discussion and planning of care throughout our lifetime is a good thing, instead of a bad thing.”

— Roland Goertz, M.D., president of the American Academy of Family Physicians, told AIS’s Health Reform Week.

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

600,000 … patients are waiting for new treatments for hepatitis C, 50% of whom have already failed conventional therapy, according to Steve Burman, CEO of Burman’s Specialty Pharmacy.

Click here to read the SPECIALTY PHARMACY NEWS article in which this datapoint appeared. (Free for SPN subscribers; $17 for non-subscribers).


People on the Move

Aetna Inc. appointed Charles Saunders, M.D., to head the company’s “strategic diversification.” Saunders was a former executive with the private equity firm Warburg Pincus....James Hendricks, M.D., has been named director of medical services at Blue Cross and Blue Shield of Oklahoma. Hendricks, a pediatrician, comes to the Blues plan after more than 30 years in private practice.


Today's Featured Health Business Job Opening

The Burchfield Group
Business Analyst - Part C
St. Paul, Minn.

Place Your Ad Here

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