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March 15, 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

Some Blues Plans Awarded Rate Increases While Other Reviews Are Still Pending
Reprinted from The AIS Report on Blue Cross and Blue Shield Plans

Blue Cross Blue Shield of Michigan and Wellmark Blue Cross Blue Shield of Iowa were recently granted rate increases, while a near 10% hike was proposed in late February by Anthem Blue Cross and Blue Shield in Maine .... Read Full Story


From the AIS Blogs
An Overlooked Area of ACO Development: Behavioral Health

As ACO developers consider payment mechanisms, Richard Gendron, M.D., vice president of Holston Medical Group in Kingsport, Tenn., suggests offering behavioral-health clinicians a new model to calculate how much of the gain-share would be attributable to better mental-health care management. What do you think? ... Read more


Quote of the Day

With Twitter, FaceBook and other social media, “you have something that can be a great tool in health care, but it can be damaging [to patient privacy] if it’s not used correctly. You can have all the policies in the world, but that’s not going to stop people from misusing them.”

— Chris Apgar, HIPAA/IT consultant and president of Apgar & Associates in Portland, Ore., told AIS’s Report on Patient Privacy.

Click here to read the REPORT ON PATIENT PRIVACY article in which this quote appeared. (Free for RPP subscribers; $17 for non-subscribers).


Today's Datapoint

96.9%…of the Obama Administration’s proposed fiscal year 2012 budget for CMS would go to Medicare and Medicaid, and another 1.3% for the Children's Health Insurance Plan (CHIP), according to the White House.



Today from Washington

People on the Move

Correctional Medical Services named Michael Champion, M.D., vice president of behavioral health. Champion has served as the firm's regional director for psychiatry in New Mexico since 2007 and will retain that responsibility in his new position....BlueChoice HealthPlan of South Carolina promoted Dave Krupa to vice president and chief marketing officer. Krupa replaces Bill Ferguson, who retired. Krupa joined BlueChoice in October.


Today's Featured Health Business Job Opening

Executive Search & Placement
Medical Director
Northern or Southern California

Place Your Ad Here

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

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AIS E-Savings Club Weekly Specials

Upcoming Webinars

Social Media: How Insurers Can Strengthen Sales, Improve Member Health and Avoid Privacy Risks
Tuesday, March 22, 2011

Click here for details.

Beyond Buy and Bill: Managing Specialty Therapies Under the Medical Benefit
Tuesday, March 29, 2011

Click here for details.

Medical Homes: Health Plan Pilots that Have Improved Outcomes and Lowered Costs
Thursday, March 31, 2011

Click here for details.

New Reform-Driven Claims and Appeals Procedures: Practical Steps Plans Should Take Now
Tuesday, April 5, 2011

Click here for details.

CMS’s New Past Performance Assessment: Steps MA and Part D Plans Must Take Now to Avoid Harsh Penalties
Thursday, April 14, 2011

Click here for details.

Setting Out-of-Network UCR Rates: Evaluating FAIR Health’s New Benchmark Data and Other Alternatives for Insurers and Employers
Thursday, April 21, 2011

Click here for details.

A Practical Guide to Federal Medical Loss Ratio Requirements
AIS's Health Business Daily