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June 9, 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

Reform Law May Extend Trust Fund’s Life, But Long-Term Solvency Impact Isn’t Clear
Reprinted from AIS’s Health Reform Week

The health reform law does buy some time for Medicare’s beleaguered hospital insurance trust fund, the 2011 Medicare Trustees Report released May 13 concluded. But with so many of the law’s health system delivery reforms yet to be tested, it remains to be seen if the statute will become a significant cost-saving measure to address the fund’s long-term solvency problems .... Read Full Story


From the AIS Blogs

Overpayments Pervasive in Established Office Visits in Some States

Established office visits appear to be a major source of errors, according to a recent audit by TrailBlazer Health Enterprises, a Medicare administrative contractor ... Read more


Quote of the Day

“From our perspective as a PBM and pharmacy, [drug] manufacturers charge what the market will bear, since most of these drugs are for very serious conditions for which patients have little competition. If the path can be cleared to bring biosimilar versions of these drugs to market from multiple manufacturers, we expect competition to drive prices down significantly.”

— Glen Stettin, M.D., chief medical officer for Medco Health Solutions, Inc., 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

17.4% … was 2010’s growth in specialty pharmacy spending, the largest increase since 2004, according to the 2011 Drug Trend Report issued by Medco Health Solutions, Inc.

Click here to read the SPECIALTY PHARMACY NEWS article in which this datapoint appeared. (Free for SPN subscribers; $17 for non-subscribers).


FierceHealthPayer News from our partner FierceMarkets

Massachusetts poised to bar nonprofit board payments

Attorney General Martha Coakley already filed a bill to end nonprofit directors from getting pay, but Sen. Mark Montigny has now attached the no-pay measure to the state budget, which could significantly fast-track the process of it becoming law, potentially ending the controversial practice as soon as July 1, reports 22News ... Read more

Today from Washington

People on the Move

ECS, a developer of medical record retrieval services, named Craig Mercure vice president of sales and Doug Spencer director of business development. Mercure was vice president of sales at MD-IT, and Spencer was executive vice president at TrueLogic Financial Corp....Hansen Medical, Inc. appointed Peter Mariani chief financial officer (CFO), effective June 20. Mariani was CFO at BMW Constructors.


Today's Featured Health Business Job Opening

Health Plan
Medical Director
Los Angeles

Place Your Ad Here

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

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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

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.

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

Click here for details.

Just Announced! Accounting for HIPAA Disclosures in EHRs: How to Comply with Onerous New HHS Rules
Thursday, July 7, 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.

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