Payer Roundup—HCSC launches innovation lab in Dallas; Tufts Health Plan inks 4 ACO contracts with providers

Aerial view of Dallas Texas
Health Care Service Corporation's new innovation lab will be in Dallas. (Getty/f11photo)

HCSC launches innovation lab in Dallas

Health Care Service Corporation, which operates Blue Cross Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma and Texas, announced the opening of its Customer First (C1) Innovation Lab. The lab, which is located in Dallas, will serve as the company’s hub for collaboration, incubation and development of new products and services. HCSC plans to use the new venture to tackle issues like rising pharmacy costs, in-patient hospital stays, cost and quality variations among providers, and healthcare access and affordability. (Release)

Tufts Health Plan partners with four provider organizations on ACOs

Tufts Health Plan has signed contracts to form Medicaid accountable care organization partnerships with four provider organizations: Atrius Health, Beth Israel Deaconess Care Organization, Cambridge Health Alliance and Boston Children's Accountable Care Organization. The insurer says the new ACOs will feature a value-based payment structure and will offer members an integrated model of care in which to receive medical, behavioral, dental and long-term support services. (Release)

Massachusetts offered Aetna hefty tax break for potential move to Boston

Before Aetna announced that it will move its headquarters from Connecticut to New York, officials in Massachusetts tried to entice the company to come to Boston instead. The state initially offered a $10 million award through an Economic Development Incentive Program, an infrastructure grant of up to $5 million and $1 million in workforce training funds—then bumped up the offer to include a $16 million EDIP award. Ultimately, though, a top aide to the governor found out via a breaking news alert that Aetna went with New York. (MassLive)

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Feds sue Cigna, Anthem, Macy’s over wellness program

The Department of Labor has filed a lawsuit against Macy’s and subsidiaries of Cigna and Anthem, claiming that the retailer’s tobacco cessation program violates federal law by failing to provide a reasonable alternative standard to avoid a $35 to $45 surcharge for individuals who couldn’t meet the standards of the program. The lawsuit also alleges that Cigna and Anthem used a less-favorable reimbursement rate to process out-of-network claims, which caused participants to overpay certain claims. (Bloomberg BNA)

Study finds ACA slowed down ambulance response times

A new study from The National Bureau of Economic Research suggests that the Affordable Care Act added “strain” to emergency response systems by extending health insurance coverage to individuals who wouldn’t otherwise have sought emergency medical services. Specifically, researchers estimate that expansions of private and Medicaid coverage under the ACA slowed down ambulance response times by an average of 19%. However, they note that the findings “provide only one piece of a much larger puzzle with regard to evaluating the costs and benefits of the ACA.” (Study)

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