Business Strategy

MCOs are looking at each segment separately to assess opportunities for small business

Modernize delivery models and help PCPs do more now and in the future

The Comprehensive Primary Care Initiative expects high performers to up their game with technology, data sharing and quality milestones

WellPoint's RBP model puts market forces to work

CoOportunity offers narrow- and tiered-network products, but don't call them HMOs

Create a valuable social media presence.

Physicians have yet to master the implications of genetic test and their relationship to treatment, while plans await outcome evidence

Plans risk losing group contracts with alternative healthcare purchasing choices becoming available.

As more individuals tap into subsidies, costs of reform will increase

Code limits the deduction that may be taken for compensation paid to officers, board members

Regulations require CEOs be informed of corporate efforts

Employers are looking to change the dynamic of benefit administration

Japan and the UK outrank the United States in infant mortality measures

Monitor main risks to prepare for regulation.

Enroll America and private web entities could be avenues for new exchange customers

Few employers say they will drop benefits or reduce workers

Innovative state experiments propel health reform forward

ACOs, bundled payment, shared savings require new capabilities and new culture

RADV audits can help by confirming that a plan has actually captured the most accurate and complete diagnostic information about its members to deliver the right care to those members based on their needs

Study reveals mixed results in expanded Medicaid plan

Massachusetts adds cost containment goals, something PPACA lacks

Transparency still has a long way to go

State boards of pharmacy would have access to proprietary data that PBMs want to protect

Plans must reconsider the benefit delivery models that employers could leverage in this post-reform world.

Four ways to deliver a value case that resonates with stakeholders.