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June 22, 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

Many Employers May Drop Coverage in ’14, Spurred by Fears About High Admin Costs
Reprinted from AIS’s Health Reform Week

Amid fresh signs that a much higher-than-anticipated number of employers intend to “pay” for eliminating health coverage to employees instead of “playing” in the reformed market in 2014, some witnesses warned a House subcommittee hearing June 2 that the reform law’s regulatory burdens are proving too much for businesses and health plans alike .... Read Full Story


From the AIS Blogs

Second Medicare Compliance Review Released

The HHS Office of Inspector General has released its second Medicare compliance review. The target: Fletcher Allen Health Care in Burlington, Vt. ... Read more


Quote of the Day

“It is often hard to tell from existing documentation whether or not the patient is actually sick, let alone sick enough to warrant an admission. It may be that the patient was an appropriate admission, but the physician’s documentation doesn’t reflect diagnostic terms that illustrate the patient’s condition and the physician’s level of concern…. [Physician documentation should] paint a picture. A specific, realistic picture. Don’t make it modern art.”

— Andrew Rothschild, a director with FTI Healthcare in Austin, Texas, told AIS’s Report on Medicare Compliance.

Click here to read the REPORT ON MEDICARE COMPLIANCE article in which this quote appeared. (Free for RMC subscribers; $17 for non-subscribers).


Today's Datapoint

$100 billion…is the magnitude of the cost-savings opportunity between 2011 and 2015 that is presented by new generic drugs entering the market, according to Steve Goldberg, M.D., vice president and chief medical officer at Express Scripts, Inc.

Click here to read the DRUG BENEFIT NEWS article in which this datapoint appeared. (Free for DBN subscribers; $17 for non-subscribers).


Today from Washington

People on the Move

HealthPlan Services appointed Michael Buda executive vice president and chief human resources officer. Buda was senior vice president of human resources and employment legal counsel for Superior Hospital Corp. Inc....UCare named Nancy Houlton its behavioral health services director. Houlton was manager of long-term care, adult protective services and managed care at Ramsey County Human Services Dept.


Today's Featured Health Business Job Opening

Arcadian Health Plan
Clinical Pharmacist
San Dimas, Calif.

Place Your Ad Here

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

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