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

April 17, 2014

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

Accountable Care Organizations

Horizon Makes Major Change in Coverage
NJBiz, April 16, 2014
Horizon Blue Cross Blue Shield of New Jersey says it is in the process of transitioning most of its members to accountable care organizations or patient-centered medical homes.

Aetna, Baptist Health System, HealthTexas Medical Group Form Accountable Care Collaboration in San Antonio
Aetna Press Release, April 11, 2014
Aetna, Tenet’s Baptist Health System and HealthTexas Medical Group introduced an accountable care collaboration and a new Aetna Whole Health product in the San Antonio area, available July 1.

MemorialCare Medical Foundation to Offer Anthem Blue Cross Enhanced Personal Health Care ACO PPO Program
Anthem Blue Cross Press Release, April 10, 2014
Anthem Blue Cross of California and MemorialCare Medical Foundation are collaborating on an accountable care organization partnership for Anthem PPO members in the Orange County and Greater Long Beach region.

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The AIS Guide to Blue Cross and Blue Shield Plans: 2014

Health Plan Business

UnitedHealth Group Reports First-Quarter Results
UnitedHealth Group Press Release, April 17, 2014
UnitedHealth Group’s first-quarter profit fell 7.8% to $1.1 billion from $1.19 billion a year earlier, the company said in a statement.

Insurance Giant Aetna Looks to Expand in the Boston Area
Boston Business Journal, April 15, 2014
Aetna is seeking to expand its presence in eastern Massachusetts and has unveiled a prominent marketing campaign at Fenway Park.

Highmark Works to Help Members With End Stage Renal Disease
Highmark Press Release, April 15, 2014
Highmark Inc. is partnering with DaVita, a division of DaVita HealthCare Partners Inc., on an integrated care management program for patients with end stage renal disease.

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Medicare Advantage News

Personnel Announcements

Dr. Martin Silverstein Named WellPoint’s Chief Strategy Officer
WellPoint Press Release, April 16, 2014
WellPoint, Inc. named Martin Silverstein, M.D., its chief strategy officer, effective April 28.

Humana Promotes Executives
Louisville Business First, April 14, 2014
Humana has promoted several executives based in Kentucky and the Midwest as part of a restructuring of its sales and marketing development teams.

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From the AIS Blogs

Lately it seems like everyone has been weighing in with their outrage over the $1,000 per day hepatitis C treatment Sovaldi. But why all the hate for Sovaldi? Why not a general pushback against pharma pricing overall? Join the conversation at the AIS Blogs.

Provider Contracting

Humana, Dignity Health Sign Agreement
Humana Press Release, April 16, 2014
Humana Inc. has reached a new network agreement that gives its commercial and Medicare Advantage members access to Dignity Health facilities in Arizona as of May 1.

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Designing Pharmacy Benefits in Health Insurance Exchanges



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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