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!

May 28, 2015

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

Health Plan Business

BCBSNM Requests 51% Rate Hike
Albuquerque Journal, May 28, 2015
Blue Cross and Blue Shield of New Mexico is asking for an average rate increase of 51% on Affordable Care Act plans in 2016.

Humana Wins Congeniality Award Four Years Running
Business Wire, May 27, 2015
Humana Inc. won the top spot for ease of doing business with providers in a study done by athenahealth.

BCNEPA CEO Eyes Huge Payout from Highmark Merger
Times Leader, May 27, 2015
Blue Cross of Northeastern Pennsylvania President and CEO Denise Cesare would receive two-and-a-half times her salary plus bonus in the event the insurer merges with Highmark Health.

Ark. Blue Cross Thanks ACA for Spike in Revenue
Arkansas Business, May 25, 2015
Arkansas Blue Cross and Blue Shield recorded a 42.6% jump in revenue for 2014, which President and CEO Mark White attributed to increased enrollment through the Affordable Care Act.

BCBSM, Aetna Settle $2B Antitrust Lawsuit
Law360, May 22, 2015
Blue Cross Blue Shield of Michigan settled a $2 billion dollar lawsuit brought by Aetna Inc. for an undisclosed amount.

Fla. Renews WellCare Healthy Kids Contract
MarketWatch, May 21, 2015
The private-public partnership Florida Healthy Kids greenlit another two-year contract with WellCare Health Plans, Inc.

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AIS's Value-Based Care News

People on the Move

Former Health Net Exec Rejoins Company
Health Net press release, May 27, 2015
Andy Ortiz rejoined Health Net, Inc. as senior vice president of organization effectiveness and chief people officer.

Anthem Exec Announces Retirement
Anthem press release, May 26, 2015
Anthem, Inc. Executive Vice President and President, Commercial and Specialty Business Division Ken Goulet is retiring later this summer.

Texas Blues Appoints Regional President
BCBSTX press release, May 21, 2015
Blue Cross and Blue Shield of Texas promoted Chief Medical Officer for the Southeast Region Robert Morrow, M.D., to president of the Houston and southeast regions.

CarePlus Names CMO
Business Wire, May 21, 2015
Humana Inc. subsidiary CarePlus Health Plans, Inc. appointed Mayda Antun, M.D., M.B.A., vice president and chief medical officer.

Anthem Names Calif. President
Anthem press release, May 21, 2015
Anthem named J. Brian Ternan president of its California operations.

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

Provider Contracting

Judge Lashes Out at UPMC, Highmark
TribLIVE, May 27, 2015
A judge withheld a ruling in the ongoing case between UPMC and Highmark Health, saying he would issue one at a later date and scolding the two companies for being selfish and ignoring the public good.

Cigna Signs Contract with Sarasota Memorial
Herald-Tribune, May 27, 2015
Cigna Corp. agreed to a new two-year contract with Sarasota Memorial Hospital.

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From the AIS Blogs

It should come as really no surprise that the MS category is a tremendous driver of specialty drug costs for health plans. After all, that therapeutic class consistently ranks in the top three specialty categories — along with inflammatory conditions and cancer — among PBMs’ drug trend reports. But a recent article from researchers at Oregon State University reveals just how much those drugs’ prices have increased even as more competitors come onto the market. Join the conversation at the AIS Blogs.

Medicare-Medicaid Dual Eligibles Database: Dual-Eligibles Data and a Wealth of Valuable Information at Your Fingertips



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