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June 16, 2011

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

Expect Fewer Expansions, Modest Boosts In Premiums, Cost Sharing in Bids for 2012
Reprinted from Medicare Advantage News

Days before the June 6 deadline for 2012 Medicare Advantage plan bids, it at least is more clear what to expect — both from the plans and CMS — than it was last year, according to actuaries and consultants working with the plans. They tell AIS there will be fewer and very targeted service-area expansion requests, modest boosts in premiums and cost sharing, and minor benefit reductions — but only in certain geographic areas .... Read Full Story


From the AIS Blogs

Customer Concentration Risk Takes Center Stage

The topic of customer concentration risk (CCR) has attracted attention in the aftermath of Medco Health Solutions, Inc.’s recent loss of the $3 billion Federal Employee Program business. The question of whether or not health plans should take a closer look at their contracts with PBMs that are perceived to have a high CCR has created some chatter among industry leaders and analysts ... Read more


Quote of the Day

The health reform law is “the biggest opportunity we’ve had in 40 years to make a dent in the widening gap [in health care quality] between people of color and the rest of the U.S. But it’s by no means a guarantee.”

— Sinsi Hernandez-Cancio, director of health equity for the left-leaning Families USA, 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

More than
$100,000…in funding for up to 75 community transformation grants, which were created under the health reform law to reduce chronic diseases, was announced recently by HHS.



FierceHealthPayer News from our partner FierceMarkets

Bill to limit nonprofit board compensation

Following public pressure, the Massachusetts Senate passed legislation that limits compensation for board members of nonprofit institutions, reports the Epoch Times ... Read more


Today from Washington

People on the Move

PLUS Diagnostics, an anatomic pathology company, promoted Adnan Savera, M.D., to chief medical officer (CMO). Savera was executive medical director and led its genitourinary pathology diagnostic services....Endocyte, Inc., a biopharmaceutical company, named Binh Nguyen, M.D., vice president of clinical affairs. Nguyen was CMO at Tigris Pharmaceuticals.


Today's Featured Health Business Job Opening

WellPoint, Inc
Investigator Sr

Place Your Ad Here

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Upcoming Webinars

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

Click here for details.

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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