Spotlight on Health Insurers
A weekly scan of actions taken by individual health plans
Spotlight on Health Insurers is a weekly review of news from the nation's leading health insurers, including coverage of exchanges, ACOs, health business news, provider contracting and personnel changes. Subscribe now to get an issue delivered to your inbox every Thursday!

February 26, 2015

This week's topics: Accountable Care OrganizationsHealth Plan BusinessPeople on the Move

Accountable Care Organizations

Aetna, Virtua Expand Agreement
Business Wire, Feb. 24, 2015
Aetna Inc. and Virtua Medical Group expanded their current accountable care agreement for Medicare Advantage members.

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Health Insurance Exchange Database: 2015 Plans and Premiums

Health Plan Business

Humana, Aetna Project Drop in MA Funding
The Wall Street Journal, Feb. 25, 2015
Humana predicted Medicare Advantage rates to fall between 1.25% and 1.75% in 2016, and Aetna projected a decrease of 1%.

SCAN Health Plan Implements New  ICD-10 System
Business Wire, Feb. 24, 2015
SCAN Health Plan, a unit of SCAN Group, finalized its implementation of ikaSystems in preparing for the ICD-10 switch slated for this fall.

Kaiser Still Lacking on Mental Health
DMHC report, Feb. 24. 2015
California’s Dept. of Managed Health Care issued a follow-up report on Kaiser Foundation Health Plan, Inc., saying the insurer still had work to do on delivery of mental health services.

Aetna Sues Houston Hospital Over Kickbacks
Law360, Feb. 23, 2015
Aetna Life Insurance Co., a division of Aetna Inc., claims a Houston hospital CEO offered kickbacks for referrals in an effort to upgrade the hospital’s facilities, resulting in as much as $120 million in overpayments. 

N.D. Public Employees Now Under Sanford’s Care
The Associated Press, Feb. 19, 2015
The state of North Dakota moved its public employees from Blue Cross Blue Shield of North Dakota to Sanford Health.

Kaiser Plans Renewable Energy Purchase
Sacramento Business Journal, Feb. 19, 2015
Kaiser Permanente said it will buy half of its energy from renewable sources by 2016.

Humana Declares Quarterly Dividend
Humana press release, Feb. 18, 2015
Humana Inc. announced a payout of $0.28 per share to stockholders, payable April 24.

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Health Plan Facts,Trends and Data 2014-2015

People on the Move

BCBSLA CEO Announces Retirement
Greater Baton Rouge Business Report, Feb. 25, 2015
Mike Reitz, president and CEO of Blue Cross and Blue Shield of Louisiana, a unit of Louisiana Health Service & Indemnity Co., plans to retire in June 2016.

Anthem Exec Named Head of AAP
AAP News, Feb. 20, 2015
Karen Remley, M.D., M.B.A., chief medical officer for Anthem Blue Cross Blue Shield in Virginia, a unit of Anthem, Inc., was named executive director and CEO of the American Academy of Pediatrics.

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From the AIS Blogs

A new lawsuit brought by a coalition of independent pharmacies points the finger at Catamaran Corp. for allegedly setting unsustainable reimbursement rates that the pharmacies aren’t made aware of until the time of claims adjudication. Do you think we’ll see more lawsuits like this as a result of generic inflation? And why aren’t health plan advocates filing complaints against the drug manufacturers themselves for the exorbitant price increases? Join the conversation at the AIS Blogs.

Medicare Advantage News



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