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May 31, 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

Large Employers to Abandon 'Grandfather' in 2012, Turn to Longer-Term Strategies
Reprinted from HEALTH PLAN WEEK

While 2012 is more than seven months away, benefits consultants say their large employer clients are ready to make bold changes to their benefit packages to ensure compliance with reform law provisions and counter coverage cost increases that continue to far outpace inflation. HPW queried more than a dozen employee benefits consultants, asking them about strategies their clients are likely to implement for the year ahead and beyond.... Read Full Story


From the AIS Blogs

Diabetes, Cancer Drugs Eclipse Generics Gains in 2010 Rx Trend

High generic utilization rates helped hold the growth in overall prescription drug spending to 3.7% in 2010, according to the 2011 Medco Drug Trend Report, released May 18. Generics constituted 71% of all prescription drugs dispensed in 2011. But the gains made by generic use were erased by the price inflation of specialty drugs, which accounted for 18.1% of all drug benefit plan spending and 70% of overall drug trend.... Read more


Quote of the Day

"The health reform law enacted last year will hurt far more than help from a small-business perspective. Additional health care costs cannot be absorbed given thin profit margins. Fewer hires and fewer hours for retained employees is the likely outcome. Our members are already reporting fewer hires, franchises and other retail store openings as a consequence."

— David French, senior VP for government relations at the National Retail Federation, 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

About 47% ... of the Medicaid population is now enrolled in 320 private managed care plans under 33 state programs, but this percentage may be about to soar.



FierceHealthcare News from our partner FierceMarkets

Most physicians not compensated for medical orders, tests, diagnostic imaging

Eighty-two percent of physicians are not compensated for prescriptions, lab tests, diagnostic imaging, hospital admissions and facility/surgery fees, according to a new survey conducted by Jackson Healthcare... Read more


Today from Washington

People on the Move

HealthAmerica named Barrie Baker, M.D., medical director for CoventryCares, the company’s Medicaid business in Pennsylvania. HealthAmerica also appointed Mark DaShiell, R.N., vice president of health services in quality improvement and named Dawn Milstead vice president of health services.


Today's Featured Health Business Job Opening

The Rawlings Group
Director of New Initiatives, Pharmacy Division
LaGrange KY (Louisville metro area), KY

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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

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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

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Health Plans vs. Drug Coupons: Tactics to Combat Brand-Name Drug Promotions
Wednesday, July 13, 2011

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

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