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May 13, 2011

Today’s issue is brought to you by ACO Business News, a hard-hitting monthly newsletter on the latest industry actions to design and create ACOs, for hospitals, physicians, health plans and their advisers.

Today's Featured Story

Specialty Docs Have Concerns Over Role in Medicare ACOs
Reprinted from ACO Business News

In reviewing CMS’s recently proposed regulations on developing ACOs, one specialty physician group responded with an immediate request: Don’t shut us out of the process .... Read Full Story


From the AIS Blogs

Health Reform: 20 Years Ago and Today

In the very first issue of Health Plan Week's predecessor newsletter, Managed Care Week, a four-page spread asks "Is The Time Ripe For A National Health Plan?" The article, published May 20, 1991, outlines a multitude of options that will sound familiar to anyone who followed the 2010 health reform debate .... Read more


Quote of the Day

“I’m not surprised [the FDA] is struggling with the regs [on online direct-to-consumer drug ads], because it’s going to be very complicated balancing basic interests in free speech and having an open business environment with the appropriate need to protect the public. With how viral social media has become, it’s an area where great harm or great good can be done. Things that are web-based can touch an awful lot of people for very little money.”

— Glen Stream, M.D., president-elect of the American Academy of Family Physicians, 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

$2,750 … with 30% coinsurance was the deductible under health insurance exchanges (under the “bronze” or lowest benefit plan) that was projected by three actuarial firms commissioned by the Kaiser Family Foundation. With no coinsurance the deductible was pegged at $6,350.

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


Today from Washington

People on the Move

Catalent Pharma Solutions, Inc. appointed Harry Jeffreys vice president of quality management systems and compliance. Jeffreys was the quality assurance executive at GE Healthcare....RxTrials, Inc. named Adam Chasse vice president of business development. Chasse was head of prime sites at Quintiles.


Today's Featured Health Business Job Opening

WellPoint, Inc.
Investigator Sr.

Place Your Ad Here

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Register for the FIS Healthcare Payment Solutions webinar, Payer and Provider Collaboration – Strategies to Ensure Mutual Success – May 26, 2011; 2:00 p.m. EDT.

Upcoming Webinars

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

Click here for details.

Global Payments: Health Plan Strategies for the Brave New World of Accountable Care
Tuesday, June 14, 2011

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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

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ACO Results and Strategies: A Case Study in Three-Way Risk Sharing
Thursday, June 30, 2011

Click here for details.

Payer Strategies to Manage High-Cost Specialty Drugs That Will Hit the Market Soon
Thursday, July 14, 2011

Click here for details.

Managed Medicare and Medicaid Factbook 2011
AIS's Health Business Daily