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

May 16, 2013

This week's topics: Accountable Care OrganizationsExchangesHealth Plan BusinessPersonnel Announcements

Accountable Care Organizations

OSF, Blue Cross and Blue Shield to Announce Partnership
Bloomington Pantagraph, May 15, 2013
OSF HealthCare and Blue Cross and Blue Shield of Illinois intend to form an accountable care organization, set to begin Jan. 1, 2014.

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Health Plan Week


Exchanges

Highmark, UPMC Expect to Dominate Exchange
TribLive, May 15, 2013
Highmark and UPMC plan to offer a wide variety of competing plans for individuals in the health insurance exchange marketplace, the insurers’ executives say.

Blue Cross Blue Shield Not Participating in Oregon Insurance Exchange
Idaho Reporter, May 14, 2013
Regence Blue Cross Blue Shield has opted not to participate in Oregon’s state health care insurance exchange, a spokesperson for the Cover Oregon insurance exchange said.

Hospital Executive Calls Anthem Insurance Plan With MaineHealth a ‘Backroom Deal’
Bangor Daily News, May 15, 2013
Health system MaineHealth has partnered with Anthem Blue Cross and Blue Shield to offer a new insurance product on Maine’s insurance exchange in what an executive from another system calls a “backroom deal.”

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Reality Check: Medicare Advantage and Health Reform Webinars by Gorman Health Group and Atlantic Information ServicesWinning Medicare Advantage
Go-to-Market Strategies for 2014

Webinar: Thursday, June 6, 2013
http://aishealth.com/marketplace/c3ag25_060613


Health Plan Business

Healthcare Industry Eyeing $120 Million From Blue Cross Merger
KBZK.com, Bozeman, Mont., May 14, 2013
If the merger between Blue Cross and Blue Shield of Montana and Health Care Service Corporation is approved, the Blues plan will have more than $120 million in its reserve account; per state law, the money must be used to create a non-profit organization.

Federal Anti-trust Lawsuits Filed Against Blue Cross Blue Shield
The Legal Examiner, May 14, 2013
Dozens of anti-trust lawsuits filed nationwide against Blue Cross Blue Shield have been consolidated before an Alabama U.S. District Court; the lawsuits assert the illegality of the Blue Cross Blue Shield Association’s licensing agreements with its plans.

Jurors Deliberating in Former Wellcare Execs' Fraud Trial
Tampa Bay Times, May 14, 2013
A federal jury on Tuesday began deliberating in the trial of four former WellCare executives accused of defrauding the state Medicaid program of nearly $30 million.

The Doctor Will See You Now: Cigna Teams with MDLIVE to Offer Health Care Access 24/7/365
Cigna Press Release, May 10, 2013
Cigna says it will work with telehealth provider MDLIVE to offer health plan customers access to 24/7/365 online video or telephone consultations with board-certified internal medicine, family practice and pediatric physicians.

Centene Lands Another California Medicaid Contract
St. Louis Business Journal, May 10, 2013
Centene is set to be awarded a contract to provide care to about 55,000 Medicaid beneficiaries in Imperial County in California, company officials said.

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From the AIS Blogs
What do you think plans will do in 2014? Will the big names like Aetna Inc. and UnitedHealth Group take a pass and be conservative on the number of public exchanges in which they participate, or will they be more active than many think and look to hook new customers into their brand? Join the conversation at the AIS Blogs.


Personnel Announcements

Cigna Names Thomas A. McCarthy as Chief Financial Officer
Cigna Press Release, May 13, 2013                                  
Cigna has announced that Thomas McCarthy will succeed Ralph Nicoletti as Executive Vice President and Chief Financial Officer, effective July 12, 2013.

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Inside Health Insurance Exchanges
 

Have breaking news or an editorial question? Email Erin Trompeter, editor of SPOTLIGHT ON HEALTH INSURERS, at etrompeter@aishealth.com. If you are interested in sponsoring SPOTLIGHT ON HEALTH INSURERS please contact Bailey Sterrett at bsterrett@aishealth.com.

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The Accountable Care Paradigm: More than Just Managed Care 2.0 (Leavitt Partners Center for Accountable Care Intelligence)

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