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July 26, 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

MA PPOs Are Seen as Continuing to Fare Well Despite Vulnerability to Pay Squeeze
Reprinted from Medicare Advantage News

At first glance, it seems as though Medicare Advantage PPOs would be more adversely affected by the developing payment squeeze triggered by the health reform law than would MA HMOs. After all, the rapidly growing PPOs generally are newer and higher in operating costs, and their looser ties with providers have contributed to generally lower CMS star ratings that will be used in determining quality bonuses. But most consultants and industry executives queried by AIS say MA PPOs’ other advantages will enable them to fare at least as well as their HMO brethren .... Read Full Story


From the AIS Blogs

Will copay cards become the norm?

At a recent webinar sponsored by AIS, industry analysts discussed the pros and cons of drug company copay cards that are used to defray patients’ out-of-pocket costs ... Read more


Quote of the Day

“States are already having trouble meeting their current Medicaid obligations and are seeking to scale back, and in some states they have scaled back. So to the extent that the debt-ceiling negotiations cut back on federal Medicaid payments, I’m not sure how this is going to bode for the supposed expansion of Medicaid in 2014.”

— Steve Wojcik, vice president for public policy at the National Business Group on Health, 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

1/3…of WellPoint, Inc.’s 875,000 increase in medical enrollment is related to the reform law provision that permits adult dependents to remain on a parent’s health insurance until age 26, WellPoint President, CEO and Chair Angela Braly reported in a recent conference call.

Click here to read the HEALTH PLAN WEEK article in which this datapoint appeared. (Free for HPW subscribers; $17 for non-subscribers).


FierceHealthPayer News from our partner FierceMarkets

Insurers criticized for preventing psychiatric care

A new study is criticizing health insurers in Massachusetts, where statewide reform has lead to innovative changes like global payments, for preventing patients from accessing timely psychiatric services ... Read more


Today from Washington

People on the Move

Jones Lang LaSalle named Wyatt Roderick vice president in the firm’s health care solutions group. Roderick was director of facilities for Group Health Cooperative in Seattle....CareFirst BlueCross BlueShield appointed Brian Silverstein, M.D., senior vice president of primary care medical home initiatives. Silverstein was senior vice president at The Camden Group, a national health care consulting organization.


Today's Featured Health Business Job Opening

University of Kansas
Director of Research Integrity
Lawrence, Kansas

Place Your Ad Here

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