Health Plan Business

From The AIS Report on Blue Cross and Blue Shield Plans - Despite strong evidence that some women with early stage breast cancer can achieve the same results with a shorter course of treatment, many radiation oncologists haven’t changed their treatment regimens, according to the results of a study published Dec. 17 in the Journal of the American Medical Association (JAMA). The study — conducted by the University of Pennsylvania, Anthem, Inc. and its outcomes research subsidiary, HealthCore — is the first to review related practice patterns to determine whether physicians are following the latest medical evidence. Read more

From The AIS Report on Blue Cross and Blue Shield Plans - Blues plan operator Anthem, Inc. is teaming up with pharma giants Boehringer Ingelheim (BI) and Eli Lilly and Co. to identify gaps in care and explore real-world effects of prescription drugs through two separate five-year research agreements. Read more

Health Plan Business Blog

By Patrick Connole - January 23, 2015
Narrow provider networks are a popular way for health plans to attract mostly individual market consumers, given the promise of lower premiums resulting from payer deals with providers to limit in-network options, thus goosing volumes for hospital systems. The theory seems to have prompted a trend...
By Patrick Connole - January 7, 2015
You have to go back before the Affordable Care Act became the most famous, or infamous, three words in health care to find the origins of an innovative new bundled payment pilot program that UnitedHealth Group’s UnitedHealthcare unit and the University of Texas MD Anderson Cancer Center unveiled in...
By Jill Brown - December 17, 2014
Engaging your physicians while educating them on the legal and regulatory details of developing an accountable care organization will take significant resources, warn two attorneys who were deeply involved in crafting a five-year commercial ACO agreement between Hawaii Pacific Health and Hawaii...

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