Spotlight on Health Insurers
A weekly scan of actions taken by individual health plans

April 24, 2014

This week's topics: Accountable Care OrganizationsExchangesHealth Plan BusinessPersonnel AnnouncementsProvider Contracting

Accountable Care Organizations

BCBSNC and Wake Forest Baptist Medical Center Launch New Center for Healthcare Innovation
Blue Cross and Blue Shield of North Carolina Press Release, April 23, 2014
Blue Cross and Blue Shield of North Carolina and Wake Forest Baptist Medical Center have launched a collaboration to provide value-based patient care through the Center for Healthcare Innovation.

Holy Spirit Health System, Capital BlueCross Report Improved Patient Health Through Accountable Care Arrangement
Capital BlueCross Press Release, April 23, 2014
Capital BlueCross and Holy Spirit Health System reported positive results from the accountable care arrangement they launched in 2013.

Aetna and Santa Clara County Individual Practice Association Form Accountable Care Collaboration and Introduce New Health Plans
Aetna Press Release, April 22, 2014
Aetna and the Santa Clara County Individual Practice Association are launching an accountable care collaboration and a new Aetna Whole Health product designed for businesses with employees who reside in Santa Clara County, Calif., available in May 2014.

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AIS's Directory of Health Plans: 2014 - Now Shipping!


CT Obamacare Enlists Just 78 Small Businesses
New Haven Independent, April 23, 2014
Access Health CT’s Small Business Health Options Program (SHOP) had sold plans to 78 businesses, a total of 330 people, as of April 8.

New Hampshire Insurance Dept. Releases Presentation on Network Adequacy
New Hampshire Insurance Department, April 23, 2014
The New Hampshire Insurance Department released a presentation outlining its plans for revising network adequacy standards in the wake of criticism of Anthem Blue Cross and Blue Shield's narrow network for individual plans sold on the exchange.

Harvard Pilgrim Joins CBIA Health Connections
CBIA Connections Press Release, April 22, 2014
Harvard Pilgrim Health Care is now a participating carrier on CBIA Health Connections, a private health insurance exchange serving Connecticut’s small businesses and their employees; the insurer’s plans will be available July 1, 2014.

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ACO Business News

Health Plan Business

Aetna Reports First-Quarter 2014 Results
Aetna Press Release, April 24, 2014
Aetna reported first-quarter 2014 operating earnings of $722 million, a 40% increase over the first quarter of 2013.

Cigna Consumer-Driven Health Plans Bend Health Cost Curve by Shifting Behaviors
Cigna Press Release, April 23, 2014
Cigna released its annual study on consumer-driven health plans (CDHPs); the study compares the claims experience of the insurer’s customers who are enrolled in a CDHP, a traditional PPO or HMO health plan.

2013 Highmark Inc. Financial Fact Sheet
Highmark Press Release, April 23, 2014
Highmark released its 2013 financial information; reporting net income of $294.1 million, a decrease from $432.2 million in 2012.

Aetna Completes Acquisition of Interglobal Group
Aetna Press Release, April 23, 2014
Aetna has completed its acquisition of United Kingdom-based InterGlobal, a company that specializes in international private medical insurance for groups and individuals in the Middle East, Asia, Africa and Europe.

Centene Corporation Reports 2014 First Quarter Results & Raises Full Year Guidance
Centene Press Release, April 22, 2014
Centene released its first-quarter 2014 financial results, including premium and service revenues of $3.4 billion, a 38% jump from the first quarter of 2013.

WellCare Seeks $365M Restitution From Convicted Execs
Tampa Bay Business Journal, April 22, 2014
WellCare Health Plans has filed a motion in federal court seeking $365 million in restitution from three former executives convicted for fraud.

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From the AIS Blogs

Academic researchers often display a fondness for using several-years-old data to form conclusions about current issues. Often those data are the best available, and the conclusions aren’t affected by the age of the data. But this may not be the case when the subject deals with payments for Medicare Advantage plans, and a recent study published by the National Bureau of Economic Research — and getting widespread attention in light of the spirited debate about 2015 MA pay rates — might be an example. Join the conversation at the AIS Blogs.

Personnel Announcements

Tenn. BlueCross Names Barclay Vice President, Provider Networks and Contracting
BlueCross BlueShield of Tennessee Press Release, April 23, 2014
BlueCross BlueShield of Tennessee has selected Marc Barclay as vice president of provider networks and contracting.

CareMore Announces Two New Senior Leaders
HeraldOnline, April 21, 2014
WellPoint subsidiary CareMore Health System named Jason Barker president of the company’s Medicare health plans and Vish Sankaran chief operations officer.

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Medicare Star Ratings: Key Steps to Prepare for Changes in 2014 and 2015

Provider Contracting

MVP, Private Doctors’ Group Sign Payment Deal
VT Digger, April 21, 2014
Health insurer MVP Health Care and Healthfirst, a Vermont association of private doctors, formed an agreement designed to keep private doctors in MVP’s network and provide quality incentives.

Healthways and Blue Cross Blue Shield of Minnesota Reach Settlement Agreement
Healthways Press Release, April 17, 2014
Healthways  agreed to pay $9.5 million to Blue Cross Blue Shield of Minnesota to resolve a contractual dispute that occurred between 2001 and 2008.

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Have breaking news or an editorial question? Email Erin Trompeter, editor of SPOTLIGHT ON HEALTH INSURERS, at If you are interested in sponsoring SPOTLIGHT ON HEALTH INSURERS please contact Bailey Sterrett at

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