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May 5, 2011

Today’s issue is brought to you by AIS’s Health Reform Week, the nation’s leading publication on the business implications of the massive changes for the health industry mandated by reform.

Today's Featured Story

Threat of Adverse Selection Raises Fears On Viability of Markets Outside Exchanges
Reprinted from AIS’s Health Reform Week

Once state health insurance exchanges become operational in 2014, individual and small-group markets will continue — and in some states might even flourish — outside of the exchanges. But the threat of adverse selection could make the world outside of exchanges restrictive or, eventually, nonexistent .... Read Full Story


From the AIS Blogs

Proposed Rule Fleshes Out Medicare Payments for Quality

A proposed rule released by CMS expands the Hospital Inpatient Quality Reporting Program, known as IQR, and builds the framework for a new quality reporting initiative for facilities paid under the Long Term Care Hospital Prospective Payment System .... Read more


Quote of the Day

New federal guidance that provides more flexibility regarding “grandfathered” status under reform “is good news…because it shows [that] regulators will allow employers the flexibility to step outside what appear to be literal boundaries of the rules to embrace value-based designs,” which employers want to do.

— Ed Fensholt, director of compliance services for Lockton Benefit Group, told AIS’s Health Reform Week.

Click here to read the AIS's HEALTH REFORM WEEK article in which this quote appeared. (Free for HRW subscribers; $17 for non-subscribers).


Today's Datapoint

40%…is the target for reductions in preventable hospital-acquired conditions (with a 20% reduction in unnecessary hospital readmissions) under the Partnership for Patients, a new public-private initiative under the reform law.



FierceHealthcare News from our partner FierceMarkets

Golden Parachutes Come Under Scrutiny

State governments desperate to close yawning budget gaps aren't just complaining about hospital executives' salaries. As the recession drags on, and even more Medicaid cuts loom, states are eyeing hospital directors' pension plans too .... Read more


Today from Washington

People on the Move

Streamline Health Solutions, Inc., a developer of document workflow tools for hospitals, named Gabriel Waters vice president of business development. Waters comes to Streamline from Carefx, where he was responsible for sales activities in the western U.S. while also serving to open new markets in Europe, the U.K. and Australia...Acura Pharmaceuticals, Inc. promoted Robert Jones to interim president and CEO. Jones was senior vice president and chief operating officer.


Today's Featured Health Business Job Opening

Epic Management, L.P.
Chief Financial Officer
Redlands, Calif.

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Upcoming Webinars

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

Click here for details.

Optimizing Drug Benefit Plan Designs for the Coming Wave of Generic Competition
Tuesday, May 17, 2011

Click here for details.

Strategies for Managing Part D Specialty Formulary Tiers
Wednesday, June 15, 2011

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Insurance Exchanges: How Health Plans and Employers Should Prepare for the Radical Changes Ahead
Tuesday, June 21, 2011

Click here for details.

Medical Loss Ratio Regs: What 2010 Data Suggest About Potentially Huge Rebates in 2011
Thursday, June 23, 2011

Click here for details.

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