AIS's Health Business Daily is a daily email newsletter with strategic business stories written by experienced AIS Health reporters, as well as other information of interest to health care business leaders — including news from the nation’s leading health insurers, developments from the federal and state governments that impact the health care industry, and exclusive datapoints from Subscribe now to get an issue delivered to your inbox every morning!
March 28, 2017

Hot Topic

Here’s a look at the growth of provider-led health plans:

Trend for Provider-Led Plans Is Being Fed By Economics of Reimbursement Models
Despite the probability that one of the stimulants for more providers forming health plans — the ACA public exchanges — faces gradual extinction under the Trump administration, market consultants expect the trend to continue regardless....

Competitors Become Co-sponsors With New Provider-Payer MA Joint Venture
New Medicare Advantage offerings from Johns Hopkins HealthCare, the population health and managed care arm of Johns Hopkins Medicine, will get a boost in their second year of serving 11 counties in Maryland...

Alabama Hospital-Run Medicaid Managed Care Gets CMS Waiver
Alabama got approval from CMS for a long-pending plan to start a hospital-run Medicaid managed care program for 650,000 beneficiaries....

American Well
Today's AIS Health Datapoint

$10.64 ... is the average 30-day retail copay for generics, in-network, for silver plans on 2017 individual marketplaces. While the average coinsurance for these plans is 21.14%, most plans use copays for generic drugs. Some plans require a deductible to be paid before cost-sharing begins.


Quote of the Day

“Merger and acquisition lawyers look at the [Bay Area Surgical Management] case and freak out. [It requires] a lot of due diligence to convince investors that not all out-of-network providers are crooks.”

— Carol Lucas, chair of law firm Buchalter PC’s Health Care Practice Group in Los Angeles, which represents surgery centers, physicians and other providers, speaking to Health Plan Week about concerns about providers’ out-of-network polices in the wake of the landmark $37 million victory Aetna Inc. won against Bay Area Surgical Management.

Click here to read the HEALTH PLAN WEEK article in which this quote appeared — "Aetna Wages ‘Scorched-Earth’ Litigation Against Outlier Out-of-Network Providers" (Free for HPW subscribers; $17 for non-subscribers.)


Advertise with AISThe Featured Story of the day may be accessed on the day it is transmitted without logging in to Thereafter, you may need to log in to access the Featured Story. If you haven’t yet registered on, please take a minute to create a free account now and get free access to thousands of articles, blogs and much more.

Content questions or suggestions should be directed to Executive Editor Jill Brown at If you are interested in advertising in AIS's HEALTH BUSINESS DAILY, please contact BJ Taylor 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 email 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

Copyright © 2017 Managed Markets Insight & Technology, LLC. 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

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

Visit AIS Health on: AISHealth  Follow AISHealth on Twitter  Follow AISHealth on Facebook  Follow AISHealth on LinkedIn