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May 27, 2011

AIS’s Health Business Daily is taking a holiday break.
The next issue will be published on Tuesday, May 31.

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

CMS Is Seen Giving Higher Star Weights to Clinical Items in Wake of Plan Comments
Reprinted from Medicare Advantage News

CMS’s desire to weight star-rating performance measures for Medicare Advantage plans is likely to result in substantially higher weights for clinical outcome measures and therefore lower weights for beneficiary satisfaction measures, several plan consultants agree.... Read Full Story


From the AIS Blogs

A Big Name for a Big Idea

Effective May 24, W. Michael Long became CEO of Essence Group Holdings Corp. (EGHC), the parent of Medicare Advantage plan operator Essence Healthcare. If his name sounds familiar, it should.... Read more


Quote of the Day

Because health plan premiums under Medicare are the same within a geographic rating region, “if you pay the physician on Park Avenue the same as a physician in Spanish Harlem…essentially the consumer in Harlem is subsidizing the payer rate for the Park Avenue specialist.”

— Rob Parke, a consulting actuary at Milliman, told AIS’s Health Plan Week

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

Nearly 70% … of the 600 large employers surveyed recently by Towers Watson expect to increase employee contributions for dependent coverage for 2012.

Click here to read the HEALTH PLAN WEEK article in which this quote appeared. (Free for HPW subscribers; $17 for non-subscribers).


Today from Washington

People on the Move

Investment banking firm Berkery Noyes named Jonathan Krieger managing director. Krieger has more than 15 years of experience in health care investment banking and will focus on the firm’s health care information technology sector….Patriot National Insurance Group named Theodore Werckman alternative market underwriting manager of its professional employer organization unit. Before joining Patriot National, Werckman was senior underwriter at Tower Group Companies.


Today's Featured Health Business Job Opening

Health Plan
Manager, Medical Management
Los Angeles and Long Beach, CA

Place Your Ad Here

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Upcoming Webinars

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

Click here for details.

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

Click here for details.

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

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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.

Health Plans vs. Drug Coupons: Tactics to Combat Brand-Name Drug Promotions
Wednesday, July 13, 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.

Medicare Advantage News
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AIS's Health Business Daily