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July 18, 2011

Today’s issue is brought to you by ACO Business News, a hard-hitting monthly newsletter on the latest industry actions to design and create ACOs, for hospitals, physicians, health plans and their advisers.

Today's Featured Story

Texas ACO That Has Improved Mortality Rates on MA Patients Will Keep Its Model
Reprinted from ACO Business News

A Texas-based primary care group that’s developed a unique model of taking care of Medicare Advantage patients through an ACO over the last 20 years wants to expand its patient base — but not necessarily venture into other markets beyond MA..... Read Full Story


From the AIS Blogs

Outcomes Differ When Two Providers Deal With Excluded Employees

The way a provider interacts with government officials can make all the difference in cases of excluded employees, as two providers involved in Medicaid recoupment cases learned recently ... Read more


Quote of the Day

“On the whole, the employer community is lukewarm on ACOs. I think they’re feeling a little bit of the ‘show me’ attitude. So I think the challenge in working this arena is to look to demonstrate the kinds of performance the purchasers are hoping for.”

— David Lansky, Ph.D., president and CEO of the Pacific Business Group on Health, San Francisco, speaking at the Second Annual Accountable Care Organization Summit on June 27.

Click here to read the ACO BUSINESS NEWS article in which this quote appeared. (Free for ABN subscribers; $17 for non-subscribers).


Today's Datapoint

14.2% … of insurers serving the individual market would have owed rebates this year had health reform’s minimum medical loss ratio provisions (which begin next year) been in effect, according to calculations by actuary David Tuomala of UnitedHealth Group.

Click here to read the AIS's HEALTH REFORM WEEK article in which this datapoint appeared. (Free for HRW subscribers; $17 for non-subscribers).


Today from Washington

People on the Move

The Substance Abuse and Mental Health Services Administration named Brian Altman legislative director. Altman was director of public policy and program development for the Suicide Prevention Action Network USA....BlueCross BlueShield of Tennessee appointed Elaine Manieri vice president of pharmacy. Manieri was vice president of clinical product management at CVS Caremark.


Today's Featured Health Business Job Opening

Health Insurance Company
Vice President of
Mid-Atlantic region

Place Your Ad Here

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