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March 18, 2011

Today’s issue is brought to you by AIS's Health Plan Week, the industry's leading source of objective business, financial and regulatory news of the health insurance industry.

Today's Featured Story

Already Rocky Provider-Payer Relationships Are Likely to Grow Even More Contentious
Reprinted from Health Plan Week

Pressure from employers to keep rates low — combined with increased scrutiny from state regulators — could force health plans to get tougher during contract negotiations with health systems. Faced with the prospect of lower reimbursement and new payment models called for by the reform law, some hospital systems are consolidating and bringing physicians on board as employees .... Read Full Story


From the AIS Blogs

Catalyst Will Buy Walgreens’ PBM for $525 Million

In a prime example of the consolidation among PBMs that continues to gather momentum, Catalyst Health Solutions, Inc. announced today it is acquiring Walgreen Health Initiatives, Inc., the PBM unit of Walgreens Co., for $525 million ... Read more


Quote of the Day

“The broker role is critical in the post-reform world. Just because the [reform] law pushes the broker in a new direction doesn’t mean the broker has to throw in the towel and go out of business. The role of the broker was destined to change even without the reform law.”

— George Pantos, executive director of the Healthcare Performance Management Institute, 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

186…of the 460 orphan drugs that are undergoing clinical trials or awaiting FDA approval are designed to treat various cancers, according to a new report by the Pharmaceutical Research and Manufacturers of America.

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


Today from Washington

People on the Move

Blue Cross Blue Shield of Arizona named Marcus Montoya vice president of network management. Montoya was vice president of government programs at UnitedHealthcare....Legal insurance provider ARAG appointed David Sherman managing director of sales. Sherman was regional director at EOI Service Co., and serves as president of the Voluntary Benefits Forum and is a member of the Workplace Benefits Association advisory board.


Today's Featured Health Business Job Opening

Confidential Medical Practice Management Company
Regional Senior Vice President - West
Western U.S.

Place Your Ad Here

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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

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

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

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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.

Medicare Advantage Marketing for 2012: Steps to Take Now to Succeed Amid Reform-Driven Changes
Tuesday, May 10, 2011

Click here for details.

AIS's Directory of Health Plans: 2011
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