April 12, 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

Self-Funding Is No Longer Just for Big Guys, But May Be Risky for Employers, Insurers
Reprinted from Health Plan Week

Rising coverage costs, combined with several reform law provisions, are prompting more small employers (i.e., fewer than 200 employees) to consider a shift to self-funded insurance coverage, according to a new report from United Benefit Advisors, LLC. Benefits consultants and equities analysts queried by AIS report a similar trend .... Read Full Story


From the AIS Blogs

Flashing the Financials

Blue Cross and Blue Shield of Minnesota's financial results for 2010 are evidence the insurer may be onto something with its "bending the trend" motto. The Blues plan released the results April 1, stating it reported 2010 revenues of $9 billion and an operating margin of 1.4%, resulting in a net operating income of $127 million. This marked the second year in a row of positive operating results after three years of losses ... Read more


Quote of the Day

“As an employer competing for the best talent, we need a benefits package comparable with the FORTUNE 500 employers we’re competing against, and that means providing benefits to domestic partners.”

— John Berry, director of the federal Office of Personnel Management, told a recent Washington, D.C., conference when discussing new incentives being requested from insurers participating in the Federal Employees Health Benefits Program.

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

$38 million … has been saved by 48,000 Medicare enrollees (an average of $800 per person) as a result of the health reform law’s 50% discount on covered brand-name drugs in the program’s “doughnut hole,” according to HHS.



FierceHealthPayer News from our partner FierceMarkets

Health Sharing Ministry Banned From Operating in Washington

Samaritan Ministries, a Christian ministry-based health plan, has been ordered to stop operating in Washington because the prominent healthcare sharing ministry is allegedly doing business illegally in the state.... Read more


Today from Washington

People on the Move

PatientPoint, a developer of self-service and revenue-cycle management applications, named Aman Bhasin, Catherine Mecker, Steven Nichols, Richard Torres and Harold Van Horn to its executive team. Bhasin will serve as senior vice president of technology services, Mecker as vice president of payor and pharmacy solutions, Nichols as vice president of physician sales, and Torres as general manager of revenue-cycle management and HIPAA compliance officer....Columbus Community Hospital in Columbus, Wis., appointed John Russell CEO. Russell was administrator of Boscobel Area Health Care in Boscobel, Wis.


Today's Featured Health Business Job Opening

The Burchfield Group
Senior Claims Auditor (with Medicare Part D and Commercial Audit Experience)
St. Paul, Minn.

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Content questions or suggestions should be directed to BJ Taylor, editor of AIS's HEALTH BUSINESS DAILY, at bjtaylor@aishealth.com. If you are interested in sponsoring AIS's HEALTH BUSINESS DAILY, please contact Bailey Sterrett at bsterrett@aishealth.com.

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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

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

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New ACO Regulations: Discover the Opportunities and Pitfalls Ahead
Thursday, May 5, 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.

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

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AIS's Directory of Health Plans: 2011
AIS's Health Business Daily