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April 6, 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

MA Plans Looking to Boost Star Ratings Form Burgeoning Market for Data Vendors
Reprinted from Medicare Advantage News

Among the many effects of Congress and CMS deciding last year to make star ratings a key element in Medicare Advantage plan payments is this: It has fostered a cottage industry of consultants and vendors working with MA plans to improve their ratings. And perhaps foremost in the strategies they are recommending are ones to improve ties with network providers, largely by supplying the providers with actionable data to improve patient care and outcomes as measured in the star ratings .... Read Full Story


From the AIS Blogs

OPM Wants to Trim Some Fat from Federal Insurance Program… Literally

The nation’s biggest provider of health insurance — the Federal Employees Health Benefits Program — wants federal employees and their families to take better care of themselves. At a meeting with carriers, John Berry, the director of the Office of Personnel Management, said he wants FEHBP to be “the leader” in employer-based health coverage ... Read more


Quote of the Day

“If you think about what a [health information network] wants, it’s data. And the data that’s most interesting to the HIE is what we have transacted for many years now – that is, medication history out of claims databases.”

— 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

$1.8 million … in hospital readmissions were avoided in the first year of BCBS of Massachusetts’ Alternative Quality Contracts, a private-sector ACO-like initiative.

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


Today from Washington

People on the Move

The National Association of Chain Drug Stores named Julie Philp director of federal government affairs, effective April 11. Philp was director of government relations for the Association of Community Pharmacists....bioVIGIL appointed Jason Howe president, CEO and director. Howe was CEO of Awarepoint Corp.


Today's Featured Health Business Job Opening

WellPoint, Inc
Investigator Sr

Place Your Ad Here

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Upcoming Webinars

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.

Outcomes-Based Contracts: Innovative Payer Deals to Improve Member Health and the Bottom Line
Tuesday, April 19, 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

Click here for details.

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

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