Visit the All-new
With archives of AIS's Health Business Daily,
New features like the News Archives, AIS Blogs and more!
(Free registration required)

Aug. 2, 2011

Today’s issue is brought to you by Drug Benefit News, biweekly news, proven cost management strategies and unique data for health plans, PBMs, pharma companies and employers.

Today's Featured Story

Copay Cards Could Be Win-Win If All Sides Work Together
Reprinted from Drug Benefit News

When it comes to the topic of drug companies’ copayment cards, the consensus among PBMs and health insurers is pretty clear. The discount cards, issued by pharmaceutical companies to defray patients’ out-of-pocket costs, interfere with payers’ ability to manage trend and the formulary process .... Read Full Story


From the AIS Blogs

Measure for Measure: How CMS Star-Rating Changes Might Hurt MA Plans

Nobody seems to be ascribing any evil intent to this, but the plans for "retiring" some quality measures used in Medicare Advantage star ratings that CMS unveiled July 27 could have some negative effects on many MA plan sponsors. That's because, observers say, the retired measures generally fall in areas either where MA plans are doing very well or where most plans are ranked at about the same levels. And the new measures to be introduced in their stead are likely to be ones in which lower scores will be prevalent ... Read more


Quote of the Day

“Right now it’s harder for many people to buy fruit than Fruit Loops; chips and Coke are a common breakfast. And since the rate of diabetes continues to soar – one-third of all Americans either have diabetes or are pre-diabetic, most with Type 2 diabetes, the kind associated with bad eating habits – and because our health care bills are on the verge of becoming truly insurmountable, this is urgent for economic sanity as well as national health.”

Mark Bittman, writing in The New York Times “Sunday Review” on July 24 about implementing taxes on unhealthy foods.


Today's Datapoint

$5,107 … was the average annual premium for small-group coverage in 2010 ($13,409 for families), according to a member survey released recently by AHIP.

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 encourage less-costly ER alternatives

Research shows that up to 20 percent of emergency room (ER) visits could be diverted to less-expensive retail sites, so health insurers like Anthem, UnitedHealth, and Kaiser Permanente are experimenting with various ways to educate their members about valid emergencies and encourage them to take advantage of less-costly alternatives for non-emergency needs, reports the Denver Post ... Read more


Today from Washington

People on the Move

Medworxx Inc., a developer of clinical patient flow tools, named Brian Goffenberg chief financial officer (CFO). Goffenberg was CFO at Wynford Inc....American CareSource Holdings appointed William Simpson president in addition to his role as chief operating officer (COO). Simpson joined the company as COO in December.


Today's Featured Health Business Job Opening

Blue Cross Blue Shield Association
Executive Director, Care Delivery Innovation

Place Your Ad Here

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

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 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

Free Forrester Health Insurance Report
Are Your Customers Loyal – or just TRAPPED?
New research reveals that customers feel little to no loyalty to health insurers.
Click Here For Complimentary Thought Leadership Papers from Forrester and Convergys

Upcoming Webinars
Save $30!

Value-Based Pharmacy Benefits: How to Increase Medication Adherence and Return on Investment
Wednesday, August 10, 2011

Click here for details.

Managing Oncology Drugs: New Challenges and Payer Solutions
Tuesday, August 23, 2011

Click here for details.

New Insurance Exchange Regs: Strategies for Health Plans, Brokers, Providers and Employers
Wednesday, August 24, 2011

Click here for details.

Hot Spots in the 2012 IPPS Regulation: Practical Strategies for Compliance Officers
Tuesday, August 30, 2011

Click here for details.

New Reform-Driven Claims and Appeals Procedures: Practical Steps Plans Should Take Now
Tuesday, September 13, 2011

Click here for details.

Encounter-Data Requirements for Medicare Advantage: How to Get Ready for the Huge Change in January
Wednesday, September 14, 2011

Click here for details.

Social Media Strategies for Insurers: How to Optimize Health Plan Online Efforts
Thursday, September 22, 2011

Click here for details.

AIS E-Savings Club Weekly Specials
AIS's Health Business Daily