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

November 20, 2014

Note: Spotlight on Health Insurers will not be published next week. The next issue will be sent on Dec. 4.

This week's topics: Accountable Care OrganizationsHealth Plan BusinessPeople on the MoveProvider Contracting

Accountable Care Organizations

Cigna Forms New ACO in Fla.
Cigna press release, Nov. 18, 2014
Cigna formed a new accountable care organization with Primary Partners LLC, the insurer’s fifth in Florida.

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Health Plan Business

Humana, Clintons Partner in Health Initiative
Mississippi Business Journal, Nov. 20, 2014
Humana Inc. and the Bill, Hillary and Chelsea Clinton Foundation have teamed up in a venture aimed at improving the collective health of Adams County in Mississippi.

Aetna Cancels Individual Plans in Okla.
The Oklahoman, Nov. 19, 2014
Aetna, Inc. is discontinuing its individual health plans in Oklahoma, affecting 8,700 members.

Calif. Regulators Say Anthem, Blue Shield Broke State Law
California Healthline, Nov. 19, 2014
California officials accused Anthem Blue Cross, a division of Anthem Insurance Companies, Inc., and Blue Shield of California of misleading members about the extent of their physician networks.

Humana Offering Payment Via CVS
Louisville Business Journal, Nov. 18, 2014
Select Humana members can now pay their premiums at CVS pharmacies.

BCBSM CEO Says Focus Should Be to Fix ACA Flaws
The Detroit News, Nov. 17, 2014
Blue Cross Blue Shield of Michigan President and CEO Dan Loepp said lawmakers should direct their efforts to fix the Affordable Care Act’s flaws rather than continuing to try and repeal it.

United Competing in Exchanges of 23 States
Star Tribune, Nov. 14, 2014
UnitedHealth Group’s UnitedHealthcare is offering health plans on 23 exchanges for 2015, up from just four in 2014.

United Bails on Mich. Dual Eligibles Pilot
Crain’s Detroit Business, Nov. 14, 2014
UnitedHealthcare is closing its Medicare Advantage dual special needs plan in Michigan and has reversed its decision to participate in Detroit’s Medicare-Medicaid dual eligibles pilot.

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Health Plan Facts,Trends and Data 2014-2015

People on the Move

NHCAA Elects CareSource Exec to Board Chair
MarketWatch, Nov. 18, 2014
The National Health Care Anti-Fraud Association (NHCAA) appointed Katherine Leff, director of the special investigations unit at CareSource, chair of the board of directors.

Highmark Health Names New HVHC CEO
Yahoo!, Nov. 13, 2014
Jim Eisen, former co-CEO of its Highmark Health unit HVHC, Inc., will assume full CEO responsibilities while continuing as president of Visionworks.

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From the AIS Blogs

A common thread at last week’s National Business Coalition on Health’s 19th Annual Conference in Washington, D.C., was a reminder from speakers that we weren’t just talking about controlling and reducing health care costs but about improving people’s health. The presentation that really humanized things, however, was on drug therapy management for children in foster care. What medication-related problems in your own pediatric population have you addressed? Join the conversation at the AIS Blogs.

Provider Contracting

Kaiser, Target Team Up for In-Store Clinics
San Jose Mercury News, Nov. 17, 2014
Kaiser Permanente is opening four clinics in southern California Target stores, expanding upon the services Target, a unit of Target Brands, Inc., currently offers in its 79 other clinics.

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Complying With Medicare Part D Pharmacy Access Rules: Strategies for Health Plans and PBMs



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