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November 30, 2012America's Health Insurance Plans

  Top Stories 
Medicare-Medicaid Dual Eligible Demonstration is here! CMS and States will be integrating healthcare delivery and payment coordination for individuals qualifying for both Medicare and Medicaid. HEALTHsuite® from RAM Technologies provides unmatched capabilities for the administration of benefits and coordination of payment for these Dual Eligible beneficiaries. (For info Click Here).
  Providers & Suppliers 
  • Leapfrog issues patient safety grades for U.S. hospitals
    The Leapfrog Group issued an updated Hospital Safety Score report this week, giving "A" grades to 790 of 2,618 hospitals. The report gave 121 facilities "D" marks, and 25 hospitals got "F" marks. Some 23% of hospitals got a higher rating than in the June report while 19% scored lower. Leapfrog's scoring methodology has been criticized by some hospitals. HealthLeaders Media (11/28) LinkedInFacebookTwitterEmail this Story
Inovalon is a healthcare technology company that combines advanced data analytics with highly targeted interventions to achieve meaningful impact in clinical outcomes and financial performance across the healthcare landscape. To see healthcare empowered, visit
  Medical Update 
  • Hyperthyroidism raises A-Fib risk in study
    Individuals with early-stage hyperthyroidism were 30% more likely to develop atrial fibrillation than those with normal thyroid function, researchers from Denmark reported in BMJ. They noted that the likelihood of atrial fibrillation was lower among hypothyroidism patients compared with those with normal thyroid function. HealthDay News (11/27) LinkedInFacebookTwitterEmail this Story
  • Study links belly fat to weaker bones, higher fracture risk in men
    U.S. researchers studied 35 obese men and found that those with deep belly fat, regardless of their body mass index and age, had weaker bones than those with more fat in the thigh and buttocks area. Overall, researchers estimated that obese men with so-called beer bellies had a 25% higher risk of bone fracture than those with more superficial fat. The study was presented at a meeting of the Radiological Society of North America. WebMD (11/28) LinkedInFacebookTwitterEmail this Story

Improve Adherence and your Stars rating. A better Medicare Advantage Plan Adherence STARS rating starts with services from an industry leader. Learn more about Adherence Services here.
  Emerging Trends 
  • Assessment formula may help predict obesity risk in infants
    Researchers at Imperial College London have developed an assessment formula, available as an online calculator, that predicts an infant's obesity risk by examining its birth weight, the parents' BMI, the number of people they live with, the mother's professional status and whether she smoked while pregnant. The findings were published in PLOS ONE. Reuters (11/28) LinkedInFacebookTwitterEmail this Story
  • AFrame's mobile monitoring device gains FDA clearance
    The FDA has given AFrame Digital 510(k) clearance to market MobileCare Monitor in the U.S. as a Class II medical device. The device, which is akin to a wristwatch, is designed to continuously monitor gait and detect falls among the elderly and other vulnerable patients, and transmit that data in real time to a caregiver's personal device using Bluetooth. (11/28) LinkedInFacebookTwitterEmail this Story
  Health Insurance Plan Company News 
  Vendor Company News 
  Pharma News 
  • Mylan gets FDA nod for generic Detrol
    Mylan received regulatory approval for its tolterodine tartrate tablets in 1-mg and 2-mg strengths to treat overactive bladder. The drug is the generic formulation of Pfizer's Detrol. Drug Store News (11/29) LinkedInFacebookTwitterEmail this Story

Visit McKesson and hear our vision around newly connected, highly collaborative healthcare at AHIP's Fall Forum 2012. Gain insights from our expert, Matthew Zubiller, VP of Decision Management, on "Moving from Volume to Value: Smart, Point-of-Care Decision Support to Align Payers and Providers," Tuesday, December 4, 3:30-4:30pm.

Interested in learning more about advertising with SmartBrief? Click here for detailed industry information and media kits.  

  Policy Watch 
  • CMS issues quality reporting waivers to storm-hit hospitals
    CMS has sent notice to quality improvement organizations notifying them of its plans to waive certain quality reporting requirements for storm-hit hospitals in Connecticut, New Jersey, New York and Rhode Island. Hospitals in these areas may have suffered damage to their records or data systems as well as to their physical facilities. (11/29) LinkedInFacebookTwitterEmail this Story
  AHIP News 
  • Learn more about Medicare, Medigap and Medicare Advantage
    “Medicare” may be a household term, but are you familiar with its eligibility guidelines, enrollment processes, benefits and costs? AHIP’s new online course, Understanding Medicare, will educate you about traditional Medicare (Parts A and B), Medigap insurance, Medicare Advantage (Part C) and Part D, the prescription drugs program. It makes a complicated subject easier to understand. Enroll today. LinkedInFacebookTwitterEmail this Story
  • Communication Strategies for a Consumer-Centric Market
    Join us from 1:00 p.m. to 2:30 p.m. ET on Dec. 5 to learn how to communicate effectively with consumers to create a positive and long-lasting member experience. The webinar will include a discussion of communication preferences including creative uses of new media, as well as examples of using data and consumer insights to refine and create highly targeted and relevant communications. Register now. LinkedInFacebookTwitterEmail this Story
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Position TitleCompany NameLocation
Project AssociateAmerica's Health Insurance Plans (AHIP)Washington, DC
Associate General CounselBMC HealthNet PlanBoston, MA
Pharmacy Customer Service ManagerHealthPartnersBloomington, MN
Vice President - Exchange BusinessMVP Health CareSchenectady or Rochester, NY
Vice President, Operations & Information TechnologyLouisiana Health Cooperative, Inc.New Orleans, LA
Sr Data AnalystCVS CaremarkNorthbrook, IL
Internal Audit DirectorUCareMinneapolis, MN
Senior Director Claims AdministrationKaiser PermanenteDenver, CO
Associate Director, CORECouncil for Affordable Quality Healthcare (CAQH)Washington, DC
Chief Executive OfficerBeth Israel Deaconess Care Organization (BIDCO)Boston, MA
Medical DirectorArizona Integrated Physicians Inc.Peoria, AZ
Sr. Director, Healthcare Quality AssuranceEvolent HealthArlington, DC
Director Compliance, Medicare Part DDirector Compliance, Medicare Part DScottsdale, AZ
Executive Vice President of Health InsuranceWisconsin Physicians Service Health InsuranceMadison, WI
Provider Network Management DirectorBlue Cross Blue Shiled of Georgia (WellPoint)Statewide, GA
Medical DirectorHarvard Pilgrim Health CareQuincy, MA
CAQH CORE Manager, Education, Outreach and Participant RelationsCouncil for Affordable Quality HealthcareWashington, DC
Click here to view more job listings.

The robbed that smiles, steals something from the thief."
--William Shakespeare,
British playwright

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