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February 28, 2017

Hot Topic

This week insurers are scrutinizing provider networks, after a Texas hospital filed for bankruptcy protection after being ordered to pay Aetna $51 million in a court case alleging the provider charged Aetna 10 times the market rate for out-of-network surgical procedures. Here’s a look at AIS’s recent coverage on the topic:

2017 Outlook: Despite Stable Rates, Employers Will Push Insurers for Savings
Health Plan Week

Trend for Provider-Led Plans Is Being Fed By Economics of Reimbursement Models
Health Plan Week

DOJ Lawsuit Against Carolinas HealthCare May Impact Contracting in Other Markets
Health Plan Week

 
Today's AIS Health Datapoint

34 million ... members are covered by Anthem, Inc., nationwide, making it the largest Blue Cross Blue Shield carrier. Anthem represents 32.12% of the total Blue Cross Blue Shield licensee market share, and 11.37% of total national market share.

From AIS’s DIRECTORY OF HEALTH PLANS

  Now accepting pre-orders for AIS's Directory of Health Plans: 2017

Quote of the Day

Anthem, Inc.’s projected 2017 Medicare enrollment growth represents “faster-than-market-average growth of 6% to 9%, as [Anthem has] been able to capitalize on the opportunities through an increasing number of 4-star plans.”

— Anthem CEO Joe Swedish told investors, according to Medicare Advantage News

Click here to read the MEDICARE ADVANTAGE NEWS article in which this quote appeared — "For 2017, Insurers Anticipate MA Growth To Hold Down Medical Costs, Lift Earnings" (Free for MAN subscribers; $17 for non-subscribers.)

 

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