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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

Only
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
Finance
Mid-Atlantic region

Place Your Ad Here
 

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

AIS's HEALTH BUSINESS DAILY is copyrighted and protected by federal law. The re-use of its content is restricted (see below). However, you are permitted to forward this e-mail to as many of your friends and colleagues as you wish, or better yet have them sign up for their own copy at http://www.magnetmail.net/actions/ atlantic_subscription.cfm, where you can also sign up for AIS's Government News of the Week. Copyright © 2011 Atlantic Information Services, Inc. (AIS). All rights reserved. It is not permissible to include all or any portion of this content on any Web site, intranet or electronic network or in any print publication, without AIS's written permission in advance. Permission requests should be directed to rbiehl@aishealth.com.

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ACO Business News
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AIS's Health Business Daily