Feb. 3, 2012

Today’s issue is brought to you by AIS’s Health Reform Week, the nation’s leading publication on the business implications of the massive changes for the health industry mandated by reform.

California Urges HHS to Reduce Carrier Flexibility Related to Essential Benefits
Reprinted from AIS’s Health Reform Week

States, which were handed the responsibility by HHS in December for setting up “essential health benefits” packages, now are firing back at the agency. California is taking the lead in urging HHS to revise its Dec. 16 guidance on a national minimum benefit standard, citing “significant concerns” with carrier flexibility, among other provisions .... Read Full Story

Link Gets Stronger Between Payment and Quality

About five years ago, CMS started down the road toward penalizing hospitals for less-than-optimal patient outcomes with potential DRG cuts for hospital-acquired conditions. But as CMS implements new quality-related programs and sharpens its knives under existing programs hospitals will start to really feel the connection between quality and payment ... Read more

“…the presidency is what really matters for managed care. If you get a Republican president, regardless of what happens in Congress, it would be a pretty big benefit for managed care because the president appoints the HHS secretary. You’d have to imagine that a Republican HHS secretary would have some very different interpretations of the reform law relative to the situation today.”

— Carl McDonald, an equities analyst at Citigroup Global Markets, told a Jan. 18 webinar hosted by AIS.

Click here to read the HEALTH PLAN WEEK article in which this quote appeared. (Free for HPW subscribers; $17 for non-subscribers).

Today's Datapoint

92% … more individual and family plan applications were received by Providence Health Plan as a result of a Web-based health insurance platform to help consumers select plans.

From HEALTH PLAN WEEK.

• Congressional Record
• Federal Register

Venable LLP named Brenda Tranchida counsel for its Washington, D.C., and Baltimore offices. Tranchida was director for the program compliance and operations group at CMS....SelectQuote Benefit Solutions appointed David Embry senior vice president of sales and client services. Embry was managing director of client service, sales and marketing for JPMorgan's Retirement Plan Services unit.

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