Need to Know: May 2014

Transitions

Premera CEO Gubby Barlow is stepping down as of Sept. 30, 2014. Current president Jeff Roe has been appointed CEO, effective Oct. 1. Barlow will remain with Premera through the end of the year in an executive capacity during the transition.

Thomas Miller has been named chief information officer at WellPoint Inc. Miller will be responsible for all enterprisewide information technology initiatives with the focus on delivering high-quality, secure, compliant and cost-effective technologies.

Business

Aetna is expanding the capabilities of one of the nation’s first private health exchanges for large employers. HR Policy Association, representing the chief human resource officers of more than 350 private sector employer, chose Aetna to create the next generation of its Retiree Health Access program.

Horizon Blue Cross Blue Shield of New Jersey(Horizon BCBSNJ) and Edison-based JFK Medical Center, through its JFK ACO, announced the launch of a collaborative accountable care organization (ACO) to improve care and patient outcomes for more than 5,000 Horizon BCBSNJ members. More than 140 doctors practicing at approximately 50 practice locations in Central New Jersey are participating in an ACO that began on April 1, 2014. Similarly, Horizon BCBSNJ and Hackensack-Physician Hospital Alliance ACO announced the launch of a collaborative ACO agreement for over 16,000 Horizon BCBSNJ members. More than 450 primary care doctors practicing at approximately 40 practices in Bergen County are participating. 

Health Management

Blue Cross and Blue Shield of North Carolina (BCBSNC) and OrthoCarolina collaborated to launch a new bundled payment program for total knee replacement surgeries. Effective March 1, 2014, BCBSNC customers can pay a single price for knee replacement surgeries with OrthoCarolina. Overall, participants are expected to save 10% to 30% on the cost of knee replacements, according to BCBSNC internal data, 2014.

Independence Blue Cross (IBC) in Philadelphia and California-based DaVitaHealthCare Partners have formed Tandigm Health. This joint venture will financially reward participating primary care physicians and provide them with analytical tools and support services to help them deliver more personalized, high-quality healthcare to as many as 60,000 IBC members in the next two years. The new network will reflect the industry shift toward paying for value rather than paying for volume.