Health Plan Strategies for Using Predictive Modeling in Underwriting


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AIS's Health Business Daily

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May 5, 2008


"There are OTC [over-the-counter] options [for treating allergies] that are equally effective as compared to much more expensive prescription counterparts....The OTC option in the allergy category costs less than $10 per month on average. The prescription alternatives cost on average $60 for generics and between $75 and $100 for brand-name alternatives."

— Christopher Medici, a spokesman for Blue Cross & Blue Shield of Rhode Island, told AIS's Drug Benefit News.

Today's Featured Story

Blues Plans Expand Hospital Pay-for-Performance Programs Into New States, Smaller Hospitals

45%

… of the more than 500 large employers (with 500+ employees) in a recent Mercer survey say they recently reviewed their plan benefits or limits for specialty or biotech drugs, up from 34% in 2005.


Metavante helps create a seamless consumer healthcare experience by enabling healthcare constituents (health plans, third party administrators, financial institutions, providers) to exchange information and funds. Visit http://marketing.metavante.com/curetheconfusion for a FREE report, "The Online Consumer Healthcare Experience Revealed." Or call 1-800-822-6758 for more information.


People On the Move
BJC HealthCare hired Kevin Roberts as senior vice president and chief financial officer (CFO), effective June 30. He succeeds Patrick Dupuis, who announced in September 2007 that he was resigning to explore other leadership opportunities. Roberts was senior vice president and CFO at University Hospitals Health System in Cleveland.…APP Pharmaceuticals, Inc., a manufacturer of multisource and branded injectable pharmaceutical products, promoted Thomas Silberg to president and CEO. He succeeded Patrick Soon-Shoing, M.D., who will remain as chairman of the board. Silberg has served as APP's president since November 2007.

Health Reform and the 2008 Elections:
What's Ahead for Health Care Access, Delivery and Financing

July 10-11, The Washington Court Hotel, Capitol Hill, Washington, D.C.
Speakers include Senators Rockefeller, Hatch and Wyden and Congressmen Stark, Waxman and Camp. You'll also hear reform perspectives from the Clinton, McCain and Obama presidential campaigns, leaders from prominent health business organizations, health policy analysts, and state legislators. Click here.

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.


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Never-Event Payment Policies: How Major Health Plans Are Getting Tough on Preventable Hospital Errors
An Audioconference
Tuesday, May 13, 2008

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Implementing 'Medical Homes' To Improve Patient Care and the Bottom Line: Steps That Health Plans and Providers Should Take
An audioconference
May 21, 2008

Register today.

AIS's DIRECTORY OF HEALTH PLANS: 2008
Features more than 4,600 key executive contacts, and contains year-end 2007 enrollment data.
Click here.



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