Iasis’ quality chief jumps to Humana
Posted on November 17, 2009 at 8:09 amJohn Cruickshank has left Iasis Healthcare after a year and a half as chief quality officer at the Franklin-based hospital company. The 52-year-old is now chief medical officer for Humana in Arizona. He joined Iasis around the time the company inked a hospitalist contract that led to eight doctors leaving the group he was running at the time.
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HealthSpring a value from the bottom up
Posted on November 12, 2009 at 12:20 pmThe analysts at Zacks say Franklin-based HealthSpring scores well on a screen that emphasizes cash flow. The health insurer (Ticker: HS) is on track to spin off more than $150 million in cash from operations this year.
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Join the club
Posted on November 10, 2009 at 1:38 pmAdvocat is planning to raise employee premiums and deductibles effective Jan 1. as it struggles with the cost of providing coverage to its workers, which rose $800,000 in the quarter. CFO Glynn Riddle said on the nursing home operator’s third-quarter earnings call today that that the company is self-insured for the first $160,000 in claims per employee and that claims in the $5,000 to $50,000 range jumped, perhaps due in part to hospitals performing more tests and procedures during a down economy.
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Biz groups on health reformers: They’ll come around
Posted on at 9:34 amHealth care trade associations are betting the Senate version of the health reform will win out in the tussle to come.
Many of the House-passed provisions may end up missing from the version being spearheaded by Senate Majority Leader Harry Reid, a Nevada Democrat. If the Senate passes a separate bill, it will have to be merged with the House plan, giving industries weeks or months to whittle away at policies they don’t like.
“Passage of the House bill is historic,” said Paul Heldman, a health-policy analyst with Potomac Research Group in Washington. “But there’s a whole other chapter in the debate yet to be written.”
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Getting paid, H1N1 style
Posted on November 4, 2009 at 12:47 pmEmdeon’s eRx Network will now help retail pharmacies get reimbursed for administering the H1N1 vaccine through electronic pharmacy claims to health insurers.
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PSYS-Aetna deal in the books
Posted on November 3, 2009 at 7:37 amPsych Solutions has wrapped up the sale of its EAP business to insurance giant Aetna and will put the $70 million in proceeds toward reducing its debt. At Sept. 30, the company’s debt-to-equity ratio stood at 1.3.
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AmeriChoice and Meharry partner for telehealth
Posted on October 27, 2009 at 7:51 amMembers of AmeriChoice by UnitedHealthcare of Tennessee who live in rural or underserved areas will have access to the physicians of Meharry Medical Group via a telehealth network announced Monday. The agreement with Meharry Medical College is an expansion of AmeriChoice’s telehealth program with Community Health Network.
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TennCare releases report on MCO performance
Posted on at 7:12 amThe Bureau of TennCare on Monday released an analysis of the 2008 performance of TennCare participating managed care organizations. The report looks at 74 measures related to effectiveness and access to care, patient satisfaction, use of services, costs and others – comparing each MCO and aggregate results against national Medicaid averages. This is first report with data on behavioral health and drug and alcohol dependence treatment. Read the full report here.
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‘Priced for maximum pessimism’
Posted on October 20, 2009 at 7:39 amHealth insurance investors are still nervous as all get out about the effect of the reform bill making its way through Capitol Hill. Still, you don’t have to go far to find portfolio managers who are upbeat about their long-term prospects even though the group’s biggest names are trailing the S&P by more than 20 percentage points this year.
“While the end result of the reform process is likely to have a negative impact on the insurers, the present discount is overpricing the risk,” the Barclays analysts said in a report.
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Principal muscles in on local health insurance market
Posted on October 12, 2009 at 3:18 pm
Iowa-based financial powerhouse Principal Financial Group is rolling out a medical provider network to take on market leaders BlueCross, Cigna and United.
“The network is an extension of our commitment to providing quality health insurance and excellent service for members, employers and health care providers. We look forward to expanding the network to new areas throughout the state,” said Marshall.
Prime Health bags Banyan
Posted on at 1:49 pm
From a release:
Prime Health Services Inc. announces today that Mr. Bobby Banyan has joined its provider contracting team as National Contract Executive. Prime Health Services Inc. is one of the nation’s largest non-risk bearing PPO and medical cost-containment companies. As one of its newest team members, Bobby will be dedicated to the continuation of building Prime Health’s nationwide PPO Network.
“Bobby will be a great asset to Prime Health as we expand our national customization efforts. Prime Health is excited to have Bobby join our team and looks forward to his success in Prime’s continued growth,” said Brian A. Sharp, President/CEO of Prime Health Services.
Bobby, son of a Four Star General, has worked with major corporations as P&L manager for the past 20 years. The past 10 years he has been focused on working directly with negotiating contractual agreements which have resulted in company growth within his market.
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Now this would be meaningful health reform
Posted on October 7, 2009 at 1:38 pmOutlining an idea that would move health insurance “away from spending other people’s money and shifting the burden to others,” Owen management professor Larry Van Horn writes in Modern Healthcare on how the auto insurance model wouldn’t be half bad if applied to health care, if only because it would get us to change our behavior.
What if I purchased auto insurance the way I receive health insurance — priced independently of conduct, with a true premium cost hidden from view that covered all preventive maintenance? I would drive like a bat out of hell. The insurance also would be so costly that I wouldn’t be able to afford it.
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Latest Senate health plan a winner for hospitals
Posted on October 6, 2009 at 1:40 pmThe nation’s hospital companies – a large number of whom call Middle Tennessee home – are set to come out ahead if the latest version of the Senate’s plan to reform health insurance becomes law. That’s in large part because a previous deal in which hospitals pledged to produce $155 billion in savings by 2019 still stands. In terms of sheer dollars, local players HCA and Community Health Systems would benefit most.
On the flip side, pharmacy benefit managers such as Caremark don’t have much to like from this new version: They’ll be required to disclose the incentives drug makers are paying them.
EMS signs transportation agreement with HealthSpring
Posted on October 1, 2009 at 7:30 amEmergency Medical Services Corp. (Ticker: EMS) announced three medical transportation and transportation management agreements through its American Medical Response division, including a deal with HealthSpring (Ticker: HS). Colorado-based AMR will provide non-emergency transportation management services to HealthSpring Medicare Advantage plan members through its Access2Care division. Combined, the three deals are worth $8 million to $9 million in annual revenue.
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Tennessee’s worst-case health care tab
Posted on September 30, 2009 at 2:36 pm
A new study commissioned by the Robert Wood Johnson Foundation sketches just how the health care system could deteriorate over the next decade if income growth lags and the cost of care rises at a decent clip. Here are some teasers for the country as a whole.
• In 29 states, the number of those without insurance would grow by more than 30%
• Nationally, spending by American businesses for their workers’ health care would double.
In Tennessee, costs under the worst-case scenario would rise by two-thirds by 2019, faster than all but three of its neighboring states. Even in the study’s best possible outcome, uncompensated care in Tennessee will rise by 69 percent to almost $2.2 billion a year and business will have to shell out $6 billion more than they are this year. For more state numbers, go to page 56 of the report.
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