Welcome to AIS Health

From Health Plan Week - In yet another year-end sign of vertical integration in the health care industry, UnitedHealth Group’s Optum unit said it has reached an agreement to buy a multistate physician group. Under the Dec. 5 agreement, Optum is to acquire DaVita Medical Group (DMG) for $4.9 billion in cash. The deal is expected to close in 2018, subject to regulatory approval. DMG will join the OptumCare division, which works with 80-plus health plans to serve millions of consumers annually through 30,000 affiliated physicians and hundreds of care facilities. Read more

From Health Plan Week - In its ongoing quest for more commercial business in Massachusetts’ highly competitive market, Neighborhood Health Plan (NHP) said Nov. 7 it will soon begin broadly offering certain prevention, rehabilitation and drug-free pain relief treatments and prescriptions cost-free to members — and waive their out-of-pocket expenses for some alternative therapies to opioids. The new benefit design is being offered across several of NHP’s commercial plan designs for large employer group customers. Not-for-profit… Read more

From Health Plan Week - Congress has set the stage for a September return to debate on stabilizing the individual health insurance market, with major changes to Medicaid funding or expansion taking a back seat. Read more

From Medicare Advantage News - In keeping with the new administration’s theme of providing Medicare Advantage organizations more flexibility, CMS on Nov. 22 unveiled a set of revisions to the MA Value-Based Insurance Design (VBID) model that grants MA organizations in certain states a limited waiver to federal uniformity requirements. Industry experts agree that the modifications, which include opening the model to 15 new states and possibly more targeted conditions, represent a significant expansion. Read more

From Drug Benefit News - Although prescription drug benefit plan cost trends are projected to be less severe for 2018, they’ll be offset by a slightly higher medical cost trend, warned the “2018 Segal Health Plan Cost Trend Survey” — Segal Consulting’s 21st annual study. The survey shows that high-deductible health plans and emphasis on wellness programs are a couple of the ways health plans are tackling cost increases. For the study, Segal researchers asked group health… Read more

It's quick and easy to sign up for FREE access to AISHealth.com!

Why do I need to register?