Health Plan Strategies for Using Predictive Modeling in Underwriting


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AIS's Health Business Daily

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March 24, 2008


"Physicians in the past have seen PBMs as maybe interfering with their practice, but now they understand they are here and here to stay. We're trying to get the word out that the PBM is there to maximize the patient's benefit, which hopefully in turn will make the physician's life easier by helping the patient control their disease and get the proper medications. The trick is how to do that and get that word out."

-- Brian Solow, M.D., medical director for clinical programs at Prescription Solutions, a pharmacy benefit management (PBM) division of UnitedHealth Group, told AIS's Drug Benefit News.

Today's Featured Story

Some Tax Preparation Software Does Not Permit Allowable Deductions for Health Savings Accounts

Nearly
92,000

…Oregonians signed up to receive one of 3,000 available applications for the Oregon Health Plan's standard benefit package, a low-income (but non-Medicaid eligible) benefit that now covers 17,700 enrollees.


Vendor Gifts and Relations:
How to Revise Your Hospital's Strategies as the Feds Crack Down

An Audioconference - March 25, 2008
Get valuable strategies for identifying and managing potential vendor gift conflicts, to help avoid possible compliance minefields and make sure patient care decisions are not influenced by vendor gift-giving. Click here to register today.

People On the Move
Maureen Zehntner was named chief executive officer of UC Irvine Medical Center. Zehntner, a registered nurse, has been interim CEO since 2005. Zehntner also will serve are associate vice chancellor for medical center affairs.…Eklin Medical Systems, Inc. appointed Dennis Ballance division manager of its newly formed Eklin Data Services Division. Eklin is a developer of digital radiography and picture archiving and communications systems. Ballance was director of hospital information technology at the University of California, Davis, Veterinary Medical Teaching Hospital.

Health Plan Pay-for-Performance Programs: The Next Generation
This 54-page report contains valuable insights you'll need to establish or modify your P4P program — including case studies from three well-respected health insurers. Click here for more information.

Today's Featured Health Business Job Opening

Brigham and Women's Hospital, Director, Billing Compliance, Boston.


Content questions or suggestions should be directed to BJ Taylor, editor of AIS's HEALTH BUSINESS DAILY, at bjtaylor@aispub.com.

If you are interested in sponsoring AIS's HEALTH BUSINESS DAILY, please contact Bailey Sterrett at bsterrett@aispub.com
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Information contained in AIS's Health Business Daily is included with the understanding that Atlantic Information Services, Inc. is not engaged in rendering legal, accounting or other professional services. If legal advice or other expert assistance is required, the services of a competent professional person should be sought.


Sponsors

Innovative Provider Payment Strategy or Capitation All Over Again?
An audioconference
April 3, 2008
Register today.

2000-2007 Survey Results: Pharmacy Benefit Trends & Data
Featuring hundreds of charts, tables and graphs on costs, benefit design, utilization and PBM market share
Click here
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The AIS Report on Blue Cross and Blue Shield Plans
Monthly news on Blues' new products, market share, financing, profitability and strategic alliances
Click here.



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