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Details of MediShield Life premiums are expected to be released soon. But while health experts say the proposed changes to MediShield Life go far enough to e…
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Washington, DC (PRWEB) June 04, 2014

Health insurer Universal American Corp., which has partnered with 34 Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs) in the last three years to offer financial and analytical support in exchange for a share of future savings, said last month it will cut loose an undisclosed number of those ACOs due to poor financial performance. For its June issue, a leading consultant interviewed by Atlantic Information Services, Inc.s ACO Business News (ABN) posits other reasons for Universal Americans decision to drop certain ACOs.

Leavitt Partners L.L.P. Director of Research David Muhlestein tells ABN that some of the organizations who didnt want to follow the Universal American game plan may get cut there could have been some personal disagreements there. Universal Americans approach has leaned heavily on impacting the cost of care in the short term by cutting certain care-related expenses, rather than on investing in care management systems and strategies that could cost more up front, but pay dividends down the road, Muhlestein explains.

However, some of the problems with individual ACOs performance could be related more to the benchmarks assigned to them by CMS, which are based on prior year spending for their specific ACO members, than to differences in care coordination philosophy, he adds. Those that were assigned easy-to-hit benchmarks have an advantage over those with more difficult benchmarks, and Universal American may be culling those that cant meet the benchmarks, Muhlestein says.

Asked to respond to Muhlesteins comments, Universal American Chairman and CEO Richard Barasch tells ABN that they are pure speculation on [Muhlesteins] part and contain several inaccuracies about our ACO strategy and Medicare Advantage business.

Universal American President and Chief Financial Officer Robert Waegelein tells ABN that the company will detail which ACOs are affected when it reports second-quarter financial results around the beginning of August. The company is waiting for final 2013 results from CMS to make its own final determinations on which ACOs stay and which will go.

We want to be very clear: Were still very much a firm believer in MSSP, Waegelein says. However, he adds, we want to invest in whats working and cease investment in whats not.

Visit http://aishealth.com/archive/nabn0614-01 to read the article in its entirety.

About ACO Business News

ACO Business News delivers timely news and business strategies on accountable care organizations for physicians and provider groups, hospitals, health plans and their advisers. The monthly newsletter covers the latest industry actions to design and create ACOs, results that are already being achieved by ACO-like entities, and HHS regulations and guidance on this provocative new trend in health care. Featuring the pros and cons of various strategies for different types of organizations, ACO Business News is designed to help readers avoid the pitfalls ahead and transform exciting ACO opportunities into winning business strategies. Visit http://aishealth.com/marketplace/aco-business-news for more information.

About Atlantic Information Services

Atlantic Information Services, Inc. (AIS) is a publishing and information company that has been serving the health care industry for more than 25 years. It develops highly targeted news, data and strategic information for managers in hospitals, health plans, medical group practices, pharmaceutical companies and other health care organizations. AIS products include print and electronic newsletters, websites, looseleafs, books, strategic reports, databases, webinars and conferences. Learn more at http://AISHealth.com.







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Welcome to another broadcast of Solidarity First! The show begins with Daniel discussing the hypocrisy of Obama’s healthcare policy and the cost we paid to have the our health insurance plan. Higher prices (due to the United States challenging generic drug use in India), and as a result more deaths overseas, means more profits for companies here. Bayer, who Obama officials are supporting, however is a German company that President Obama is fighting for. Unenforceable by the WTO rules, Obama’s secret trade deal called the Trans Pacific Partnership (TPP), can subvert local laws and WTO rules thus putting countries of heavy poverty at terrible risk. Chris updates us on civilian uprisings around the world with his state of the revolution. Topics include: Billy of Occupy Tampa and Occupy Wallstreet was arrested after chaining himself to an exit ramp in New York at Brooklyn bridge. Told that there was an ambulance waiting to leave, it was later found out no such ambulance existed. Chalkupy had a sit in. President Obama signing an executive order to control all communication in the name of national security and more! Next Randy jumps into the round table to discuss the United States policitians supporting terrorist group Mujahadin-e Khalq (MEK). A federal judge ruled that President Obama must remove the MEK off the terrorist watch list or pursue criminal prosecution against those listed above. Obama however will remove them off the watch list and instead focus efforts on setting

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Subscribe to Reshape To Live’s Youtube channel for free fitness workouts! Tweet this workout (bit.ly Up Top Down Low!- June Body Weight Challenge #8 Round 1 Burpee push up box jumps Jumping Pull ups Spider man Stability ball push ups Overhand rows Round 2 Jump squats Reverse pull ups Bench dips Underhand rows Each Exercise 1 minute. Do each Round 3 times; Interval Timer: (bit.ly Follow us on Twitter: @reshape_jake (bit.ly Friend us on Facebook: on.fb.me Medical Disclaimer: Always consult your physician before beginning any exercise program. This general information is not intended to diagnose any medical condition or to replace your healthcare professional. Consult with your healthcare professional to design an appropriate exercise prescription. If you experience any pain or difficulty with these exercises, stop and consult your healthcare provider. All content created and owned by reshape to live unless otherwise noted. Music by Flatline is Failure used with permission.
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Rachel Maddow points out the role of the Affordable Care Act in solving the problem of America’s terrible health care system, and talks with Dahlia Lithwick, senior editor and legal correspondent for Slate, about the bigger picture of Thursday’s Supreme Court ruling upholding the Affordable Care Act’s individual mandate. From the June 28th, 2012 edition of The Rachel Maddow Show on MSNBC.
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Washington, DC (PRWEB) June 12, 2012

Atlantic Information Services, Inc., publisher of Health Plan Week and AIS’s Health Reform Week, is pleased to announce its June 26 webinar, Health Information Exchanges: Strategies for Building Next-Generation Insurance Products and Payment Models. See webinar details at http://aishealth.com/marketplace/c2m22_062612.

Pressure to develop new payment models and innovative plan designs is rapidly changing the face of health insurance. Health plans that fail to embrace health information exchanges (HIEs) which are a cornerstone of industry reform are likely to be left in the dust. Managing benefits soon will come down to real-time decisions made with clinical data across the spectrum of a patients care. But determining exactly how to incorporate HIEs is a major challenge for health insurers and providers.

Health insurers are beginning to see HIEs as essential tools that can help them build new payment models and forge provider alliances that reduce waste and incent physicians to keep members out of the hospital. Aetna Inc., for example, recently paid $ 500 million to acquire Medicity, a Utah-based HIE vendor.

For insurers, HIEs offer the potential for greater connectivity with network providers. But while HIEs and other efficiency-improving technologies can create value by reducing utilization, such as duplicate tests and unnecessary treatments, such reductions translate to lost revenue for providers, so health plans must tread carefully.

During the webinar, Bradley M. Fluegel, an executive-in-residence at Health Evolution Partners, Charles Kennedy, M.D., chief executive officer of Accountable Care Solutions, and Sherri Zink, vice president of Medical Informatics at BlueCross BlueShield of Tennessee, will provide deep insight into these and other related topics:


How insurers can transition from claims-based data to HIEs when measuring provider quality.
How to use HIEs to build new payment models and forge provider alliances that reduce waste and incent caregivers.
The pros and cons of buying or building an HIE system, or contracting with an existing one.
How companies such as Aetna and UnitedHealth plan to recoup the nearly $ 1 billion theyve invested in HIE firms.
How insurers can use HIEs to integrate financial risk underwriting with clinical care management.
How to use HIEs to complete Healthcare Effectiveness Data and Information Set (HEDIS) requirements.

Visit http://aishealth.com/marketplace/c2m22_062612 for more details and registration information.

About AIS

AIS develops highly targeted news, data and strategies for managers in hospitals, health plans, medical group practices, pharmaceutical companies and other health care organizations. Learn more at http://www.AISHealth.com.







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