News in brief - May 1, 2006

AMA Insurance selects Cigna for Part D - Aetna merges clinical programs - Study: Baby boomers not driving hospital growth - Computer Sciences shops for buyer - N.J. Blues plan offers PHRs

AMA Insurance selects Cigna for Part D

The AMA Insurance Agency has partnered with Cigna to market a Medicare Part D prescription drug plan to Medicare-eligible physicians and their spouses.

In choosing Cigna, the AMA Insurance Agency, a wholly owned subsidiary of the AMA, said Cigna's plan is not a sponsored program of the AMA but was selected among several carriers with a national scope, and its open formulary, which provides the best chance that a prescription will be covered, was key to its selection.

The selection of Cigna is not an exclusive one. The AMA Insurance Agency said it would not rule out offering an additional provider option to accommodate physicians.

The AMA Insurance Agency has about 25,000 seniors and spouses who currently are participating in one of the AMA-sponsored Medicare Supplement plans.

Cigna said partnering with the AMA Insurance Agency furthers their goal of growing the Medicare prescription drug business, which was formed in May 2005 when Cigna partnered with Sunrise, Fla.-based NationsHealth, a provider of medical products and prescription discount services to Medicare patients.

Aetna merges clinical programs

Aetna says it has merged its case management and disease management programs to achieve greater continuity of care and help members better manage and improve health.

Under the Aetna Health Connections program, the plan will focus on providing health support and information services covering 30 chronic conditions to members. The plan will use technology to analyze lab results to identify potential gaps in care that may have occurred when case and disease management of the same patient were handled by different nurses, said Charles Cutler, MD, Aetna's national medical director for quality and clinical integration.

"Previously you might have had a case manager who would be calling about your heart disease and a disease management nurse calling you about your diabetes," he said. "Now we've got one nurse who's got the training and [evidence-based] content to be able to manage both simultaneously."

Study: Baby boomers not driving hospital growth

A recent study says local population trends and medical care technology advances are likely to be more responsible for driving hospital construction than a usual reason cited -- aging baby boomers.

The study by the Center for Studying Health System Change found that between 2005 and 2015, population aging will account for an increase of utilization of inpatient services of only about 0.74% per year, or 7.6% over the whole period, compared with a projected overall 64.8% increase in inpatient utilization during the same period. Instead, local population trends and medical technology advances will play a much more significant role in driving community need for additional inpatient hospital capacity, the study said.

The figures were calculated using federal data on all-payer severity-adjusted diagnosis-related group relative charge weights and U.S. Census Bureau population projections. They reflect the per-person increase in resource use including cost, kinds of services and expenditures related to those services.

The study said the aging population is often cited as one of the reasons behind the sharp increase in hospital construction in recent years. And the American Hospital Assn. has noted that factor in discussions about the construction boom.

Caroline Steinberg, vice president of the AHA, said the boom can be attributed to many factors. She said the study was flawed because it did not account for those other drivers. "The study fails to factor in the advances made in health care and how those advances affect the demand for hospital care," she said.

"Today's elderly patient is much more likely to be living with heart disease, diabetes and other chronic conditions," she added. "But that same patient also has the opportunity to live an active life made possible by significant advances in medicine."

Computer Sciences shops for buyer

Computer Sciences Corp., one of four companies designing and implementing a national health network for the British government, announced in April that it hired an investment banking firm to explore strategic alternatives, including a sale of the company, "in response to recent expressions of interest."

CSC declined to comment to AMNews on whether the restructuring is related to problems with its contract with Britain's National Health Service, saying it had no comment beyond what was in its press release. Britain's effort to build a national health network has been plagued by software delivery delays and has drawn the ire of physicians as well as politicians who worry that it will turn out to be a colossal flop.

The $11-billion project already has claimed Accenture Ltd. as a casualty. In March, the company announced that it was taking a $450 million charge to cover losses it expects to incur on its NHS contracts over the next three years.

Separately, the large technology consulting and outsourcing services firm in El Segundo, Calif., announced a restructuring plan to improve future cash flow and earnings. Under the plan, CSC will shed 5,000 jobs or 6% of its work force over the next two years. Most of the cuts will occur in Europe and result in the company taking $375 million in pre-tax charges in fiscal years 2007 and 2008, the company said in a press release.

Some Wall Street analysts told newspapers that they viewed CSC's restructuring plan as a way for the company to draw a minimum bid of at least $65 a share from potential buyers. Last year, the company held talks to be acquired by Lockheed Martin and three private-equity firms, but those talks never advanced beyond the preliminary stage.

N.J. Blues plan offers PHRs

Horizon Blue Cross Blue Shield of New Jersey announced in April that it is offering a service that will enable its members to access online tools to assess, track and manage their health information.

Using those tools, members will be able, among other things, to create an online personal health record and to assess information about their medications and data on the cost of 350 procedures, conditions, tests and office visits.

Vote refines AMA stance on health reform
The AMA House of Delegates rejected attempts to rescind support of a U.S. House health reform bill and any new government-sponsored health insurance plan during the 2009 Interim Meeting.
Story - AMA House - Slideshow