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Feb. 3, 2011

Today’s issue is brought to you by The AIS Report on Blue Cross and Blue Shield Plans, a hard-hitting independent monthly newsletter on new products, market share, strategies, conversions, financing, profitability and strategic alliances of BC/BS plans. (Not affiliated with the Blue Cross and Blue Shield Association or its member companies.)

Today's Featured Story

Blues Plans Develop Medical Homes on Path to Quality, Cost Improvements
Reprinted from The AIS Report on Blue Cross and Blue Shield Plans

Several Blue Cross and Blue Shield plans are moving forward on patient-centered medical home development and starting discussions with providers about accountable care organization (ACO) formation. And a handful of Blues plans actually have ACO pilots in operation .... Read Full Story


Quote of the Day

“There’s no such thing as a ‘virtual’ [accountable care organization]. To be an ACO as defined by [the reform] statute, you have to be a corporate entity, have enough primary care providers to serve 5,000 [Medicare] members,” and meet other statutory criteria.

— Bruce Merlin Fried, Washington, D.C.-based partner at SNR Denton LLP, told AIS’s ACO Business News.

Click here to read the ACO BUSINESS NEWS article in which this quote appeared. (Free for ABN subscribers; $17 for non-subscribers).


Today's Datapoint

$450 million....more would be in the Medicare trust funds had Medicare Advantage plans not received payments in 2007 (the most recent year for which data are available) that were not immediately used, which plans then invested to earn $376 million themselves, according to an HHS Office of Inspector General report.



Today from Washington

People on the Move

Cambridge Health Alliance, a Harvard University-affiliated health care system, promoted Somava Stout, M.D., to vice president for patient-centered medical home development. Stout was medical director at CHA's Revere Family Health Center....Radia, Inc., a large radiology/vascular practice in Everett, Wash., named Mary Kelly, M.D., chief medical officer. Since 2007, she has been director of imaging at the Swedish Ballard Women's Imaging Center.


Today's Featured Health Business Job Opening

American Medical and Life Insurance Company
Chief Compliance Officer
Virtual East Coast

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