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Aug. 5, 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 Plans Strengthen Financial Ties With Providers to Cope With Tight Pay Outlook
Reprinted from Medicare Advantage News

Many Medicare Advantage plans are boosting their financial ties with providers that care for their members. The ways in which they are doing it run the gamut from organizing physicians into independent practice associations (IPAs) for contracting, to building and operating their own health care centers, to offering large bonuses based on outcomes. While a few insurers actually are purchasing provider groups, and more may do so, partly in response to health reform law provisions such as payment cuts and minimum medical loss ratios, in most of the new arrangements the ties are short of that, albeit much stronger than in previous years .... Read Full Story


From the AIS Blogs

Anxiety Lingers on State Exchanges

Will they or won’t they? Can they or can’t they?

Insurers and state officials alike expressed concerns at a recent policy conference that states — in particular those run by Republican governors — will be able to successfully implement health insurance exchanges under the ambitious deadlines outlined by recent regulations ... Read more


Quote of the Day

“Broadening the scope of mandated preventive services that go beyond or conflict with the current evidence-based guidelines will increase the cost of coverage for individuals, families, and employers.”

— AHIP spokesperson Robert Zirkelbach, responding to the Institute of Medicine’s recent recommendation that would require insurers to offer female members a variety of contraceptives without copayments.



Today's Datapoint

12% …of the 750 small business surveyed recently by the National Federation of Independent Business indicated they either had their health insurance plans terminated or were told that their plan would not be available in the future.



Today from Washington

People on the Move

Omnicare, Inc. promoted Dan Thomas to senior vice president and general manager, RxCrossroads. Thomas was vice president of distribution operations, RxCrossroads....Wellmark Blue Cross and Blue Shield Chief Financial Officer and Treasurer Dave Southwell will retire in September. He will be replaced by David Brown, who joined Wellmark in May.


Today's Featured Health Business Job Opening

Director, Health Plan Operations
New York City

Place Your Ad Here

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

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Tuesday, August 30, 2011

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

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Encounter-Data Requirements for Medicare Advantage: How to Get Ready for the Huge Change in January
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Thursday, September 22, 2011

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Medicare Advantage News
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AIS's Health Business Daily