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!

September 22, 2016

This week's topics: Health Insurance ExchangesHealth Plan BusinessLegal/Regulatory IssuesPeople on the MoveProvider ContractingValue-Based Care

Health Insurance Exchanges

Analyst: Anthem Likely Will Exit ACA Exchanges in 2018
Bloomberg BNA, Sept. 19, 2016
Goldman Sachs analysts forecast Anthem, Inc., facing significant financial losses, will exit the exchanges in 2018.

One Insurer Leaves, Another Enters Maricopa County's Healthcare Exchange
KJZZ, Sept. 15, 2016
Centene will enter the Arizona exchange market in 2017, following Cigna Corp’s exit. Cigna said Centene’s Ariz. exchange members will be able to use Cigna’s provider network.

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Health Plan Business

AMA Says Anthem-Cigna Deal Would Shrink Insurer Choices in CT
CT Mirror, Sept. 21, 2016
The American Medical Association warns a lack of competition in the insurance market caused by mega-mergers would cause premium increases, reduced provider options.

CaliforniaChoice Adds Two New Plans for Small Businesses
Press release, Sept. 20, 2016
The private exchange will offer two new high-deductible health plans for groups of two to 100 employees, effective Dec. 1, 2016.

Kaiser Permanente’s ‘Health Hub’ Design Named a Finalist in Fast Company’s 2016 Innovation Awards
Kaiser press release, Sept. 19, 2016
The insurer received praise for its “life-integration” care model, which encourages members to take an active role in their care to improve health outcomes.

Humana’s Bold Goal Population Health Program Seeks to Topple Barriers to Healthy Living
MedCity News, Sept. 15, 2016
The initiative seeks to improve overall member health by targeting six “priority conditions” that respond to lifestyle changes, such as hypertension and diabetes.

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Health Plan Facts, Trends and Data: 2016-2017

Legal/Regulatory Issues

Aetna, Others Appeal PA's Estimated $5B Medicaid Contract Awards
Healthcare Dive, Sept. 21, 2016
Four insurers that lost contract bids for Pennsylvania’s new long-term care program have filed an appeal with the state’s Department of Human Services.

Cigna Responds to DOJ Antitrust Case
Hartford Courant, Sept. 20, 2016
The insurer posited its sale to Anthem would increase consumer access to affordable healthcare, rather than limit market competition.

Aetna Confident, but Not Cocky, About Humana DOJ Trial
Louisville Business First, Sept. 16, 2016
Aetna CFO Shawn Guertin did not rule out divesting even more of its health plan business to ensure its planned purchase of Humana is approved.

Blue Cross Blue Shield of NC Fined $3.6 Million
WLOS, Sept. 15, 2016
The insurer was fined due to an unusually high volume of customer complaints, including unreliable customer service, billing errors, missing ID cards and false coverage cancellations.

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From the AIS Blogs

'Grey’s' Couldn’t Save McDreamy, but Can Patrick Dempsey Save the Exchanges? Join the conversation at the AIS Blogs.

People on the Move

Molina Healthcare Names Britt Travis Vice President of Medicare Sales
Molina press release, Sept. 16, 2016
The former Highmark, Inc. sales exec will lead Molina’s Medicare sales operations.

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The AIS Guide to Blue Cross and Blue Shield Plans

Provider Contracting

BlueCross BlueShield WNY Announces Focus, Expands Tiered-Benefit Options
BCBS of Western New York press release, Sept. 21, 2016
The insurer will launch a new product line in January 2017, offering lower costs to members at Catholic Health and Catholic Medical Partners affiliates.

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Value-Based Care

Anthem Blue Cross and Blue Shield Joins National Comprehensive Primary Care Plus Initiative in Ohio and Northern Kentucky
Anthem BCBS press release, Sept. 15, 2016
The insurer will participate in CMS’s five-year multi-payer program that aims to refocus primary care on patient-centered care, improving member outcomes and affordability.

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Have breaking news or an editorial question? Email Executive Editor Jill Brown at If you are interested in advertising in SPOTLIGHT ON HEALTH INSURERS please contact Bailey Sterrett at

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