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

April 10, 2014

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

Accountable Care Organizations

Holy Cross Physician Partners and Cigna Start Collaborative Care Program to Improve Health and Lower Costs in Broward and Palm Beach Counties
Cigna Press Release, April 7, 2014
Cigna and Holy Cross Physician Partners launched a collaborative care initiative, the insurer’s first in South Florida and its fourth in the state.

Hartford HealthCare’s Integrated Care Partners and Cigna Start Collaborative Care Program to Improve Health and Lower Costs
Cigna Press Release, April 7, 2014
Cigna and Hartford HealthCare’s Integrated Care Partners launched a collaborative care initiative, the insurer’s seventh collaborative care initiative in Connecticut.

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Health Plan Facts,Trends and Data 2013-2014

Exchanges

HealthSource RI Releases Enrollment, Demographic and Volume Data Through March 31
HealthSource RI, April 3, 2014
HealthSource RI has released public exchange enrollment and demographic data and volume metrics through March 31.

Harvard Pilgrim Likely to Join Maine’s Health Insurance Marketplace
Portland Press Herald, April 4, 2014
Harvard Pilgrim Health Care company officials have said that it will join Maine’s federal health insurance marketplace next year.

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Data Sources for Rate-Setting in ACOs, Exchanges and Narrow Networks

Health Plan Business

Mass. Blue Cross Cuts Back on Painkiller Prescriptions
Boston Globe, April 8, 2014
Blue Cross Blue Shield of Massachusetts says it slashed prescriptions of narcotic painkillers by an estimated 6.6 million pills to curb abuse.

Independence Blue Cross and DaVita HealthCare Partners Announce Joint Venture
Independence Blue Cross Press Release, April 8, 2014
Independence Blue Cross and DaVita HealthCare Partners have teamed up to create Tandigm Health, a Philadelphia-based joint venture that will partner with primary care physicians to provide enhanced care delivery resources.

Centene Corporation Purchases a Noncontrolling Interest in Spanish Health Management Group
Centene Press Release, April 7, 2014
Centene Corporation says it signed a definitive agreement to buy a noncontrolling interest in Ribera Salud S.A., a health management group based in Valencia, Spain. 
 
HCSC and Community Partners Reach More Than Six Million Children Through Health and Wellness Initiatives
HCSC Press Release, April 7, 2014
Health Care Service Corporation’s Social Responsibility Report stated that the company collaborated with hundreds of community partners to improve the health of more than 6.7 million children since 2011.

Harvard Pilgrim Health Care Granted License to Operate in Connecticut
Harvard Pilgrim Press Release, April 3, 2014
Harvard Pilgrim Health Care says it has received the necessary state approvals to begin offering health coverage to Connecticut consumers.

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From the AIS Blogs

The trend toward MA plans and provider organizations working closer together took a new turn with last month’s announcement of a collaboration between WellPoint’s CareMore Health System and Emory Healthcare. What do you think about this new arrangement? Is this the wave of the future, as MA payment rates keep getting pushed down and provider cooperation becomes more vital? Will it succeed when a hospital system has a clear interest to fill up its beds? Are MA plans and hospital operators ready to be real “bedfellows”? Join the conversation at the AIS Blogs.


Personnel Announcements

Magellan Health Services Announces Daniel M. Parietti as CEO of AlphaCare
Magellan Press Release, April 7, 2014
Magellan Health Services Inc. said that Daniel M. Parietti has been selected as the chief executive officer of AlphaCare, a plan that serves New York's long-term care and dual eligible populations; Magellan recently completed a “strategic investment” in AlphaCare and now owns 65% of the company.

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The AIS Report on Blue Cross and Blue Shield Plans

Provider Contracting

Metroplex No Longer Part of Blue Cross Blue Shield of Texas Network
News Channel 25, April 7, 2014
Metroplex Hospital and the Adventist Health Systems ended their contract with BlueCross BlueShield Texas after a disagreement about reimbursement rates. 

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

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