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Medicare Advantage News
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. Sign up for an $87 two-month trial subscription today.

December 1, 2016

Today's Featured Story

Where ACA, Medicaid Businesses Lag for Health Plans, Medicare Advantage Picks Up the Slack
Reprinted from Medicare Advantage News

As publicly traded carriers with multiple lines of business reported third-quarter 2016 earnings from mid-October through Nov. 1, Medicare Advantage products largely helped insurers offset losses in the Affordable Care Act (ACA) exchange marketplaces and/or stagnation in the Medicaid segment. And insurers that have enjoyed rapid Medicaid growth due to expansions under the ACA are now looking to expand their MA footprint after seeing improved performance in those products.... Read Full Story


Quote of the Day

“We think [$70.4 million in ACO savings in the past year by Anthem, Inc.] is a significant number. And it’s probably best to think of it in terms of reduction in the expected trend. Generally when we see these kinds of numbers we are looking for a percentage of the expected trend that would have occurred had the program not been in place. It has made a big difference in the bending of the cost curve down.”

— Michael Belman, M.D., Anthem Medical Director for Provider Enablement, told AIS’s Health Plan Week.

Click here to read the HEALTH PLAN WEEK article in which this quote appeared — "Plans Tout New ACO Results, Programs as Anthem, UnitedHealth Expand Their Efforts" (Free for HPW subscribers; $17 for non-subscribers.)


Today's Datapoint

Up to
500 ... WellCare Health Plans, Inc. Medicare Advantage members in Arkansas, Mississippi and Tennessee with chronic conditions will participate in an in-home telemonitoring pilot.



Today from Washington

People on the Move
Consortium Health Plans appointed James P. (Jim) McNary president and CEO, succeeding Miriam (Mimi) Leonard. McNary most recently was Mercer’s North America Regional Business Leader for Health and Benefits....The Pharmaceutical Research and Manufacturers of America promoted Robert Zirkelbach to executive vice president of public affairs. He succeeds Josephine Martin, who said she is leaving the association to pursue new opportunities. Zirkelbach has served as senior vice president of communications at PhRMA since 2014.

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