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March 11, 2013America's Health Insurance Plans

  Top Stories 
 
  • Americans show optimism on health but may lack access to resources
    Despite data showing widespread obesity and diabetes, 90% of Americans see themselves as healthy, according to a survey by Penn, Schoen & Berland, while 81% see people in their communities as healthy. Respondents listed regular access to doctors and health care facilities as well as healthy food choices among the most important factors in their health. However, respondents who valued community health resources most had limited access to them. Nurse.com (3/9) LinkedInFacebookTwitterEmail this Story
 Download Case Study: Reduce Rx Costs and Improve Member Health
Denying high-priced Rx claims may contain costs in the short term, but this practice can lead to poor adherence and complications for patients. Download this case study to learn how health plans can reduce drug spend with more affordable medication alternatives and provider and member education.
 

  Providers & Suppliers 
  • Health care industry adds 32,000 jobs in February
    Data from the U.S. Labor Department showed the health care industry generated 32,000 new jobs in February. Nursing homes added 9,000 new personnel, while hospitals also added about 9,000 positions, the report noted. Physician practices and outpatient centers added 14,000 jobs. The Hill/Healthwatch blog (3/8) LinkedInFacebookTwitterEmail this Story
How Much Do You Really Need to Make? The Answer May Shock You
Rather than focus on what you can afford to pull out of the business to cover your living expenses, you need to focus on how much you need to earn at your business in order to afford the lifestyle you want to have. This is where the Personal Earnings Goal, or PEG, comes into play. Learn how to calculate your PEG and find out how much you really need to make.

  Medical Update 
 
  • Study finds mixed results for benign oophorectomy
    A study in Obstetrics & Gynecology found women who choose bilateral oophorectomy during hysterectomy for benign reasons may have a lower risk of ovarian cancer death than women who keep their ovaries, but the procedure did not reduce risk of other mortality and was linked to higher mortality risk among some of those who had not used estrogen therapy. Women who face high risk of ovarian and breast cancer should strongly consider the procedure, researchers noted, but "the association of oophorectomy with increased mortality in the overall population has substantial public health implications." Medscape (free registration) (3/8) LinkedInFacebookTwitterEmail this Story
  • Brisk walking improves stroke survivors' quality of life
    Survivors of ischemic or hemorrhagic stroke who participated in a brisk outdoor walking program for three months had greater improvement in quality of life scores than a massage therapy group, a study found. The walking group did better in six-minute endurance tests and had lower resting heart rates compared with the massage group. The findings appear in the journal Stroke. MyHealthNewsDaily.com (3/7) LinkedInFacebookTwitterEmail this Story
Transformational Journeys: Modern Business Planning
Harvard Business Review explores why CFO's and their finance organizations must adapt to the changing landscape of their markets and how big data, organizational collaboration, and new cloud-based planning and analysis technologies are driving successful change.
Click here to access the report.

  Emerging Trends 
 
How episodes of care help cut costs and improve quality.
Health care costs are unsustainably high and health outcomes are suboptimal. To curb these trends, the incentive and movement toward value-based care is gaining momentum. This paper describes the advanced analytics that can assist health care organizations balance cost reduction and quality improvement through analysis of episodes of care.

  Health Insurance Plan Company News 
  Vendor Company News 
 
  Hot Topics 

Top five news stories selected by AHIP Solutions SmartBrief readers in the past week.

  • Results based on number of times each story was clicked by readers.
  Pharma News 
  • Flu vaccine strains endorsed by FDA panel for 2013-2014
    The FDA's Vaccines and Related Biological Products Advisory Committee endorsed a slightly different influenza vaccine composition for the 2013-2014 flu season, compared with that of the previous season. The committee recommended substituting two vaccine strains while retaining the A/California/7/2009pdm09-like virus. The committee also released recommendations for quadrivalent vaccines, noting that "global influenza virus surveillance data related to epidemiology and antigenic characteristics, serological responses to 2012-2013 seasonal vaccines, and the availability of candidate strains and reagents" were used as the basis for the recommendations. Medscape (free registration) (3/7) LinkedInFacebookTwitterEmail this Story
  • Drug curbs chest pain in diabetes patients
    Data on 927 diabetes patients showed those who took Gilead Sciences' angina drug Ranexa had 3.8 episodes of chest pain per week, while those who received a placebo experienced 4.3 per week. Ranexa-treated patients also required less nitroglycerin, researchers reported at the American College of Cardiology meeting. Reuters (3/10) LinkedInFacebookTwitterEmail this Story
  Policy Watch 
  • ONC cites improved use of EHR functions under MU effort
    The use of certain EHR functions such as active drug lists among acute care hospitals has improved under the federal meaningful use effort, according to the ONC, citing data from the American Hospital Association. The data, presented at the HIMSS13 conference, also indicated that 16 of the 24 MU goals analyzed had an adoption rate of 80% or more in 2012. Health Data Management (3/6) LinkedInFacebookTwitterEmail this Story
  AHIP News 
  • Inspiring sessions fill the agenda at Institute 2013
    You’ll leave the general sessions at Institute 2013 energized and ready to tackle the challenges ahead. Sessions include: “Frontline Payer-Provider Innovations Transforming Local Care Delivery”; “Shared Risk, Shared Opportunities”; “Cost Containment Strategies for an Evolving Marketplace”; “Meeting Expectations in a Changing Health Care System: Stakeholder Perspectives”; “Accelerating Disruptive Innovation throughout Health Care”; and “Where Technology, Genomics and Consumerism Can Take Health Care.” Register now. LinkedInFacebookTwitterEmail this Story
  • Protect Medicare Advantage
    Proposed changes to Medicare Advantage payments will impact the 14 million beneficiaries who rely on this critically important part of Medicare. Combined with the cuts included in the health reform law, these changes will likely result in higher out-of-pocket costs, reduced benefits and fewer health care choices. Join the Coalition for Medicare Choices to preserve Medicare Advantage. LinkedInFacebookTwitterEmail this Story
  • PPO Direct—Helping health plans expand their networks
    PPO Direct brings PPO network members exposure to an audience of potential payers and administrators looking to expand their provider network. Penn Highlands, a member of PPO Direct, is a regional provider network which includes 50 hospitals and over 4,100 physicians in western Pennsylvania, including high specialty facilities. LinkedInFacebookTwitterEmail this Story
Learn more about AHIP ->About AHIP  |  Join AHIP  |  Educational Opportunities
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Position TitleCompany NameLocation
Health Plan and Payor CounselKaiser PermanenteMultiple Locations, United States
Manager, Financial Controls and Commission Administration Geisinger Health PlanDanville, PA
Chief Operating OfficerHealth Alliance Medical PlansUrbana, IL
Contract Review and Compliance AttorneyAmerica's Health Insurance Plans (AHIP)Washington, DC
Director, Enterprise Data GroupThe Centers for Medicare and MedicaidWoodlawn, MD, MD
Manager, Payor RelationsThe joint CommissionOakbrook Terrace, IL
Vice President-Management and PerformanceUnited Health GroupNationwide, United States
Senior Director, Product Innovation and Development Cleveland Clinic Lyndhurst CampusCleveland, OH
Medicare Product ManagerRegence Portland, OR
Vice President, Network Development and Provider RelationsLouisiana Health Cooperative, Inc.New Orleans, LA
Chief Executive OfficerLouisiana Health Cooperative, Inc.New Orleans, LA
Vice President, Clinical Care IntegrationLouisiana Health Cooperative, Inc.New Orleans, LA
Vice President and Chief Financial OfficerLouisiana Health Cooperative Inc. (LAHC)Metarie, LA
Vice President, Operations & Information TechnologyLouisiana Health Cooperative, Inc.New Orleans, LA
Associate Medical DirectorUCareMinneapolis, MN
Integrated Market Medical ExecutiveKindred HealthcareLas Vegas, NV
Vice President, Provider Relations & CredentialingConfidentialWyomissing, PA
Vice President, Health Plan OperationsSatellite Health Plan, Inc.San Jose, CA
CAQH Managing Director, Finance and AdministrationCouncil for Affordable Quality HealthcareWashington, DC
Director of Product Management, UPDCouncil for Affordable Quality Healthcare (CAQH)Washington, DC
CAQH CORE Manager, Education, Outreach and Participant RelationsCouncil for Affordable Quality HealthcareWashington, DC
Click here to view more job listings.

  SmartQuote 
The greatest way to live with honor in this world is to be what we pretend to be."
--Socrates,
Greek philosopher


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