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March 29, 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

Tufts Seeks to Enter Medicaid Arena by Acquiring Network Health
Reprinted from Medicare Advantage News

The board of directors of Tufts Health Plan voted unanimously on March 1 to move forward in a bid to purchase a controlling share of Cambridge Health Alliance’s managed care plan, Network Health. The companies would not disclose the purchase price. The deal would give Tufts approximately 170,000 Massachusetts Medicaid beneficiaries and help the selling Cambridge, Mass.-based health system transition to an accountable care organization. Some in the industry see this as the continuation of a wave of these types of partnerships between health plans and providers .... Read Full Story


From the AIS Blogs

Maybe Lady Gaga Will Write a Theme Song for Aetna…

A ‘90s rock band has released a “theme song” for AMERIGROUP Corp. The company announced late last month that The Verve Pipe has written a song for the Medicaid managed care company .... Read more


Quote of the Day

“PBMs are looking at [Health Information Exchange] strategies and how they can participate and provide better and more information on their patients. I don’t think every PBM will share data with every HIE, if those HIEs don’t have the right consent mechanisms in place, if they don’t have the right policies and procedures for security and privacy.”

— Ken Majkowski, Pharm.D., vice president for strategy and innovation at SureScripts, told AIS’s Drug Benefit News.

Click here to read the DRUG BENEFIT NEWS article in which this quote appeared. (Free for DBN subscribers; $17 for non-subscribers).


Today's Datapoint

More than
90%…of health care leaders surveyed recently by Commonwealth Fund/Modern Healthcare say the health reform law is moving in the right direction, with nearly seven in 10 favoring few or no changes in its provisions.



Today from Washington

People on the Move

CenterPointe Hospital in St. Louis, Mo., appointed Jeffrey Pevnick, M.D., medical director of the progressive partial hospitalization program, and Narendir Soorya medical director of its adolescent intensive outpatient program. Pevnick was medical director of intake and triage for Unity-Hyland Behavioral Health, and Soorya was a child psychiatrist and assistant clinical director of children's services at Malcolm Bliss Mental Health Center....Managed Care Organization Professional Dynamics, Inc. named Paula Baker vice president of its Account Management Services group. Baker was clinical manager at Bunch & Associates, a company providing risk management consulting services to the hospital and health care industry.


Today's Featured Health Business Job Opening

Mayo Clinic
Division Chair – Government Relations
Rochester, Minn.

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

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

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

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Payer Strategies to Manage High-Cost Specialty Drugs That Will Hit the Market Soon
Thursday, May 12, 2011

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