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Feb. 7, 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

Lower Medicare Advantage Star Ratings, Payment Cuts Put Pressure on MA Plans’ Medical Loss Ratio Compliance
Reprinted from Medicare Advantage News

Lower star ratings can increase the downward revenue pressures Medicare Advantage plans will experience as a result of payment reforms, and create challenges for meeting the 85% minimum medical loss ratio requirement MA plans will face starting in 2014 .... Read Full Story


Quote of the Day

“The jury is a bit out on the tiered-network concept. I don’t yet have confidence in tiered networks as being a true mechanism of change. They haven’t yet really shown that they’re working from the vantage point of driving different provider behavior.”

— Maureen Fahey, a Los Angeles-based partner and national lead for health care reform at KPMG, 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

$65 million … over 10 years could be saved under the Mississippi Medicaid program by moving pharmacy benefits from a fee-for-service program to a PBM, according to a study by The Lewin Group.



Today from Washington

People on the Move

David Blumenthal, M.D., HHS's national coordinator for health information technology, said he will leave this spring to return to Harvard University. Before joining HHS in 2009, Blumenthal was a professor of medicine and health care policy at Harvard....WellPoint Inc. promoted Dan McCoy to senior vice president of service operations. McCoy was vice president of operations


Today's Featured Health Business Job Opening

HCA (Hospital Corporation Of America)
Director, Billing and Compliance
Nashville, Tenn.

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