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Health Plan Business
After 10 Years, Blue Shield of California Must Share $14 Billion CalPERS ContractFrom The AIS Report on Blue Cross and Blue Shield Plans - After a decade of having the business to itself, Blue Shield of California will be one of five health plan operators administering a new $14 billion, five-year contract for HMOs offered through the California Public Employees’ Retirement System (CalPERS). Blue Shield of California’s HMOs now cover more than 400,000 CalPERS members. Beginning on Jan. 1, 2014, Blue Shield of California will be joined by Health Net, Inc., WellPoint, Inc. subsidiary Anthem Blue Cross, Sharp Health Plan and UnitedHealth Group in administering HMOs for the program. Read more
CCIIO Head Answers Skeptics, Insists Exchanges Will Be ReadyFrom Health Plan Week - Despite the best efforts of a top CMS official to ease concerns over whether insurance exchanges will be ready to open on time this fall, it seems that nobody will be shocked if just such a delay occurs. Gary Cohen, director of CMS’s Center for Consumer Information and Insurance Oversight (CCIIO), on April 24 testified before a House Energy and Commerce oversight panel, and insisted all systems are go for… Read more
Figuring Out Medicaid Expansion Keeps Plans Scrambling to Adapt to State MovesFrom Health Plan Week - Now that it appears likely that the Arkansas alternative to expand its Medicaid population through health insurance exchanges will become a reality, health plans are being forced to recalibrate what effect this will have on their marketplace strategies for next year, consultants and industry observers say. The Arkansas legislature gave final approval to the alternative plan on April 18, which now awaits the governor’s signature. CMS will review the proposal… Read more
Health Plan Data
On the Health Plan Bookshelf
Health Plan Business Blog
By Patrick Connole - May 7, 2013
Health insurers, like all stakeholders, have no idea what the advent of public health insurance exchanges next year will look like. Will these new marketplaces even get off the ground in time for open enrollment this fall? Will there be a flood or a trickle of new lives for insurers to cover in the...
By Rick Biehl - April 17, 2013
On several recent occasions, I’ve witnessed first-hand the operation of hospital emergency rooms, as a patient and while accompanying family members. Two things stand out about these three separate experiences: (1) how hard-working and fantastic all of the individuals were who treated us; and (2)...
By Jill Brown - April 15, 2013
Cambridge, Mass.-based Mount Auburn Hospital may be moving downriver toward full global risk, with more than 150 physician employees, a 513-physician-member independent practice association (IPA), one-third of hospital revenue from risk payers and bragging rights as the first hospital to enter into...
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