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, value-based health care arrangements, provider contracting and personnel changes. Subscribe now to get an issue delivered to your inbox every Thursday!

October 8, 2015

This week's topics: Health Plan BusinessPeople on the MoveProvider Contracting

Health Plan Business

United Launches Obesity YouTube Channel
Business Wire, Oct. 7, 2015
UnitedHealth Group’s UnitedHealthcare unit is tackling obesity and diabetes through a YouTube channel for members that features a “Hollywood cast.”

Horizon Members Appeal Dismissal of Breach Suit
Law360, Oct. 7, 2015
Members of Horizon Blue Cross Blue Shield of New Jersey appealed the dismissal of a class-action lawsuit stemming from an 840,000-record data breach when two laptops were stolen.

United Expands MA Services in Ohio
BusinessWire, Oct. 5, 2015
UnitedHealthcare will be offering Medicare Advantage plans for the first time in the Toledo area.

BCBSA Sues Health Plan Over Logo
KGW, Oct. 5, 2015
The Blue Cross Blue Shield Association is suing Zoom+ Performance Health Insurance because of similarities in the two organization’s emblems.  

CHI Debuts New MA Plan
Business Record, Oct. 2, 2015
Catholic Health Initiatives is stepping into the Medicare Advantage ring in the greater Des Moines area with a new plan called HarvestPlains Health.

BCBSND Sees Profit Growth
Grand Forks Herald, Oct. 1, 2015
Blue Cross Blue Shield of North Dakota is performing well after struggling with profit losses in 2013.

U of M, Johns Hopkins Unveil MA Plans
The Baltimore Sun, Oct. 1, 2015
Both the University of Maryland and Johns Hopkins HealthCare will offer Medicare Advantage plans for seniors in 2016.

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Health Plan Facts, Trends and Data: 2015-2016

People on the Move

Aetna Picks Former United Exec to Oversee Humana Deal
Louisville Business First, Oct. 7, 2015
Aetna Inc. selected former UnitedHealthcare executive Rick Jelinek to head up integration efforts if its proposed acquisition of Humana Inc. wins approval.

Amerigroup Florida, Simply Healthcare Name Medicaid Head
Business Wire, Oct. 6, 2015
Amerigroup Florida and Simply Healthcare Plans appointed Lourdes Rivas plan president of their state Medicaid business.

HCSC Adds Army Vet to Leadership
HCSC press release, Oct. 6, 2015
Health Care Service Corp. named Andy Napoli senior vice president and chief customer service officer.

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Anthem’s Cancer Care Quality Program: Pathways to Improve Care and Reduce Costs

Provider Contracting

UPMC, Highmark Battle in State Supreme Court
Pittsburgh Post-Gazette, Oct. 7, 2015
UPMC and Highmark Health delivered oral arguments to the state Supreme Court in their dispute over Highmark’s Medicare Advantage members.

Lawmakers Call for AG Review of Horizon Tiered Plan
NJBIZ, Oct. 6, 2015
The state isn’t done with Horizon Blue Cross Blue Shield of New Jersey and its plan to assign different levels of out-of-pocket costs to different hospitals, as state lawmakers asked the attorney general to investigate.

Aetna Asks for Sanctions in $120M Kickback Case
Law360, Oct. 3, 2015
Aetna asked a court to enter sanctions against the Texas hospital with which it is embroiled in a pricey fraud and kickback lawsuit, saying the health system’s counterclaim is nothing but a copy of Aetna’s.

Trina Health Calls Out Ala. Blues for Diabetes Coverage
Trina Health press release, Oct. 1, 2015
Trina Health of Alabama, which opened two diabetes clinics this year, took an unusual shot at Blue Cross and Blue Shield of Alabama, issuing a press release accusing the insurer of denying patients coverage.

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From the AIS Blogs

At least five states have passed laws just this year to either require or encourage the use of naloxone rescue kits in schools to combat overdose related to heroin or prescription painkillers. CVS Health Corp. and Blue Cross & Blue Shield of Rhode Island are funding the efforts of a statewide task force to combat addiction and overdose in their home state. How do you think insurers or PBMs can get more involved in tackling the opioid crisis? Join the conversation at the AIS Blogs.

AIS’s Medicare and Medicaid Market Data: 2015



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