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!

August 27, 2015

This week's topics: Health Plan BusinessPeople on the MoveProvider ContractingValue-Based Care

Health Plan Business

BCBSNM Leaves State Exchange
Albuquerque Journal, Aug. 26, 2015
Health Care Service Corp. unit Blue Cross and Blue Shield of New Mexico said it will not participate in the state exchange in 2016, following the state’s rejection of its requested 51% increase.

BCBSNC Defends Proposed Rate Hike
The News & Observer, Aug. 26, 2015
Blue Cross and Blue Shield of North Carolina said it spent $365 million more on medical claims in 2014 than is required under the Affordable Care Act.

United Leads “Highly Concentrated” MA Market
The New York Times, Aug. 25, 2015
A new report from The Commonwealth Fund found that UnitedHealth Group, Humana Inc. and Aetna Inc. dominate a national Medicare Advantage market with little competition.

Cigna Vindicated in Wellness Program Suit
Law360, Aug. 24, 2015
An appellate court cleared Cigna Corp. of stealing trade secrets from Vitality wellness program provider Discovery.

Humana Hires 600 Temp Employees
Louisville Business First, Aug. 24, 2015
Humana is hiring 600 temporary workers to assist in Medicare Advantage enrollments.

Molina Expects to Gain $300M in HealthPlus Deal
Crain’s Detroit Business, Aug. 23, 2015
Molina Healthcare, Inc. is projecting a revenue increase of $300 million when it closes its acquisition of HealthPlus of Michigan next month.

BCNEPA Hit With Suit Over $90M Donation
Citizen’s Voice, Aug. 22, 2015
Blue Cross of Northeastern Pennsylvania, now a part of Highmark Health, is facing a class-action lawsuit from Plains Township over $90 million in donations it gave to charity.

Humana Selects Lead Creative Agency
AdWeek, Aug. 21, 2015
Humana picked BBDO New York as its lead creative agency following a four-month review.

UCare Ups Premium Request in Minn.
Star Tribune, Aug. 21, 2015
UCare increased its average premium request in Minnesota from 12% to 27%, citing increasing medical costs and pricing errors.

Aetna Hires Lobbyists for Humana Deal
Louisville Business First, Aug. 20, 2015
Aetna hired a slew of Washington lobbyists as it gears up to face federal antitrust regulators for its acquisition of Humana.

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People on the Move

BCBST Appoints New CEO
BCBST press release, Aug. 21, 2015
BlueCross BlueShield of Tennessee named J.D. Hickey CEO, succeeding retiring CEO Bill Gracey.

Louisiana Blues Appoints New CIO
BCBSLA press release, Aug. 20, 2015
Blue Cross and Blue Shield of Louisiana named Anthony Tardugno chief information and security officer.

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Medicare Advantage News

Provider Contracting

Aetna Inks Deal With Baton Rouge General
The Advocate, Aug. 24, 2015
Aetna added Baton Rouge General to its network for the first time since 2011.

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From the AIS Blogs

What do you think of the CMS proposal to try out a bundled payment program for knee and hip replacements in the Medicare program? Is it going to add fuel to the fire for new payment models, or will its flaws (as some say) make it a nonstarter? Join the conversation at the AIS Blogs.

Value-Based Care

Aetna Teams With MemorialCare in ACO
Orange County Business Journal, Aug. 26, 2015
Aetna is partnering with MemorialCare Health System in West Hartford, Conn., in an accountable care organization.

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