September 2012

National Edition
In this Issue
1. News
A Survey of Hospital Readmissions

A Survey of Hospital Readmissions Where Are We in 2012

During the week of August 20th, The Readmissions Web Summit, Readmissions News and Payers & Providers jointly sponsored an online survey of health plan and healthcare professionals. This survey was conducted by MCOL and focused on hospital readmission issues and trends. Survey participants typically have a more active interest in issues pertaining to hospital readmissions. We asked participants to respond to seven items: 1. Please categorize your organization. 2. I am devoting more/less/about the same amount of time and resources on readmission issues than a year ago 3. The current CMS definition of all cause readmission is 4. The proper time frame for counting preventable readmissions is 5. To motivate providers to do a better job at preventing unnecessary readmissions we need 6. We have analytics that helps us identify patients at high risk of readmission 7. Before discharge from the hospital we do patient education that involves (choose all that apply): A physician, A nurse case manager, A pharmacist, A nutritionist, A social worker Heres what we found: 84% percent of respondents said that more time and resources are being devoted to hospital readmissions issues compared to last year. Of these respondents, 42.7% said there was significantly more and 41.3% said somewhat more. Only 4% of respondents said that there was a smaller amount of more time and resources devoted to readmission issues than a year ago. The remainder of respondents (12%) said that the time and resources spent were at about the same level as a year ago. How Much Time and Resources are Being Devoted on Readmission Issues Compared to a Year Ago

3. Vitals
Results from the KFF/HRET 2012 Employer Survey, U.S. Healthcare Employees by Industry Sector, Percent Uninsured in US by Year, Unnecessary Health Spending

4. California
CDPH Fines 14 Hospitals $825,000, SCAN Pays $323.7M To Settle Suit Briefs - Arbitrator Says Marin General Won Case, Rideout Health Rebrands

5. Midwest
HealthPartners, Park Nicollet Merge, Illinois Hospital CEO Resigns Briefs - Michigan Researchers Caution Against Tight Insulin Control, HCSC, Lung Association Work On Asthma Initiative

6. WebinarsWhite Papers
Recent and Upcoming Events The Many Stories of One Litigious Physician Healthcare and Campaign Finance in California

7. Marketplace
Employment Advertising Opportunities Paid Subscriptions

8. Order Form
Payers & Providers Order Form

Volume 2, Issue 9 August, 2012

www.payersandproviders.com

continued on page 2
2012, by Payers & Providers Publishing LLC and MCOL. All rights reserved

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MARKETPLACE/EMPLOYMENT NEWS

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Health Benefit Exchange continued

There was slight variation in respondents answers when broken down by organization category. Respondents from the health plan and hospital categories both had over 50% responding that time and resources spent were somewhat more while in over half of each category, other provider and other responded that there was significantly more. Those from the hospital category were the most likely to say that some degree of more time and resources were spent on hospital readmission issues, with 92.9% answering that way. On the opposite end, other providers were the least likely to say that either somewhat or significantly more time and resources were spent on readmissions with 72.7% answering this way. A plurality of respondents, 47.2%, think that the current CMS definition of all cause readmission is OK, but could use some tweaking. A smaller amount, 30.6% think it needs serious ework and a small contingent of 8.3% think it is totally inappropriate. Only 13.9% of respondents had a fully positive outlook of the definition, saying it was right on the money. The current CMS definition of all cause readmission is: Overall Right on the money OK, but could use some tweaking Need serious e-work Totally inappropriate 13.9% 47.2% 30.6% 8.3%

While 54.7% of overall respondents thought that financial penalties, incentives and public reporting together would motivate providers, respondents from the other provider category did not agree. Only 18.2% of these respondents thought that combination would work. Those from the other provider category were more inclined to say that financial penalties combined with incentives were the proper way to motivate with 63.6% responding that way, which was much higher than the 11.8% of health plan respondents and 21.4% of hospital respondents who answered as such. 9.3% of respondents said that incentives only would work and 5.3% said public reporting alone would work, these percentages were mainly consistent when broken down by category. What is Needed to Motivate Providers to Do a Better Job at Preventing Unnecessary Readmissions

Respondents who categorized their organization as a health plan were the most accepting of CMSs definition of all cause readmission with 82.4% saying it was either OK or right on the money. Those who categorized their organization as a hospital were the least satisfied with the CMS definition, just over 50% of these respondents saying it either needed serious e-work or was totally inappropriate. When asked what the proper time frame for counting preventable readmissions is, respondents were mainly in agreement. 71.2% said that the proper time frame is 30 days and 20.5% said 60 days. 2.7% of respondents each said that the proper time frame was 90 days, 6 months, or one year. These overall numbers were consistent to those when broken down by category. When asked what is needed to motivate providers to do a better job at preventing unnecessary readmissions, respondents were unanimous in saying that financial penalties alone will not work. There was not a single respondent who thought financial penalties on their own could motivate providers. Other answers to this question, including when broken down by category did not have this kind of agreement.

A large majority of respondents (89%) said their organization either has analytics that help identify patients at high risk of readmission (38.4%) or are working on it (50.7%). Health plan respondents and other providers were more likely to currently have analytics, with over 50% of each responding this way. The health plan category was the only group to have no respondents saying their organization did not have analytics and were not working on it. Those in the other category were the most likely to say that their organization does not currently and is not working on putting in place analytics that help identify patients with 17.6% of these respondents answering this way. Finally, respondents were asked, before discharge from the hospital patient education involves, and were given the options; a physician, a nurse case manager, a pharmacist, a nutritionist or a social worker, and told to choose all that applies. Nurse case managers were the most popular answer with 71.4% of respondents saying their pre discharge patient education involves them. No other option had a majority of respondents saying their patient education involved them. 24.7% said a physician was involved, 35.1% said a social worker, 24.7% each said a physician or a pharmacist and only 13% said a nutritionist. Hospitals were the only category to have over 50% of respondents answer any other option besides a nurse case manager with 51.7% saying their education involved a social worker.

2012, by Payers & Providers Publishing LLC and MCOL. All rights reserved

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MARKETPLACE/EMPLOYMENT VITALS
LISTS from
Percent Uninsured in US by Year

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Results from the KFF/HRET 2012 Employer Survey

Results were released from the Kaiser Family Foundation/Health Research & Educational Trust (HRET) 2012 Employer Health Benefits Survey, their 14th annual survey, which found annual premiums for employer-sponsored family health coverage reached $15,745 this year, up 4 percent from last year, with workers on average paying $4,316 toward the cost of their coverage. Average Annual Premiums for Covered Workers, for HMOs by Region, 2012
Region Northeast Midwest South West All Regions Annual

$6,102 $5,532 $5,478 $5,600 $5,668

1.2011 15.7% 2. 2010 16.3% 3. 2009 16.1% 4. 2008 14.9% 5. 2007 14.7% 6. 2006 15.2% 7. 2005 14.6% 8. 2004 14.3% 9. 2003 14.6% 10. 2002 13.9%
Source: U.S. Census Bureau http://www.census.gov/prod/2012pubs/p60-243.pdf

Source: 2012 Kaiser/HRET Employer Health Benefits Survey (EHBS), Kaiser Faimly Foundation, September 2012, http://ehbs.kff.org/

Check out more healthsprocket lists at: www.healthsprocket.com

U.S. Healthcare Employees by Industry Sector Change from: July 2012 - Aug. 2012 Unnecessary Health Spending
Industry Health care Ambulatory health care service Offices of physicians Outpatient care centers Home health care services Hospitals Nursing and residential care facilities Nursing care facilities (in thousands) 16.7 14.2 0.7 1.2 7.2 5.7 -3.2 -2.6

MCOLBlog: Round Up the Usual Suspects $210 $190 $130 $105 $75 $55 unnecessary services excessive administrative costs inefficiently delivered services prices that are too high fraud missed prevention opportunities

Includes other industries, not shown separately. Includes ambulatory health care services, hospitals, and nursing and residential care facilities. Source: U.S. Bureau of Labor Statistics http://www.bls.gov/news.release/empsit.t17.htm

Data source: Institute of Medicine, Best Care at Lower Cost http://www.iom.edu/Reports/2012/Best-Care-at-Lower-Cost-The-Path-toContinuously-Learning-Health-Care-in-America/Report-Brief.aspx?page=1

2012, by Payers & Providers Publishing LLC and MCOL. All rights reserved

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MARKETPLACE/EMPLOYMENT CALIFORNIA

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In Brief
Arbitrator Says Marin General Won Case
Marin General Hospital received a fraction of what it was seeking from Sutter Health to settle a years-long dispute over siphoned revenues. Nevertheless, Marin was declared the prevailing party earlier this week by the arbitrator who decided the case earlier this year. Arbitrator Rebecca Westerfield, a retired judge, ordered Sutter earlier this summer to pay Marin $21.5 million, far less than the $120 million it sought from the Sacramento-based hospital chain. Marin had claimed Sutter had siphoned revenue from the facility during the 25 years it had operated the hospital under a lease agreement. Westerfield ruled against Marins specific claim about siphoning revenue, but did order Sutter to reimburse the hospital for money it appropriated for its own employee pension plan, the under recruitment of physicians and other peripheral issues. With Westerfields declaration that Marin prevailed in the litigation, it allows Marin to seek reimbursement for its legal fees, which officials said amounted to millions of dollars.

CDPH Fines 14 Hospitals $825,000

Hedges on Improving Glacial Appeals Process
The California Department of Public Health levied $825,000 worth of penalties against 14 hospitals late last week for serious safety breaches that led to the deaths of five patients. However, the agency had scant details about plans to speed up a painfully slow appeals process that has delayed the collection of about $1.4 million in fines. The CDPH has issued a total of 221 administrative penalties and levied $8.425 million in fines. It has collected about $6.7 million to date, and granted fine reductions of about $350,000. However, 28 hospitals are appealing penalties, or about one in seven levied, and have yet to pay any fines. The appeals process includes a hearing in front of a state administrative law judge. CDPH officials confirmed that just a single hearing has taken place. In that 2010 hearing, the agency withdrew a penalty levied against Mad River Community Hospital after a day of testimony. Only two more appeals are currently scheduled for hearings. Some hospitals are still contesting penalties levied in 2007, when the CDPH first began issuing them. We are looking at our internal processes to handle appeals as effectively as possible, said Debby Rogers, deputy director of CDPHs Center for Health Care Quality. Rogers declined to provide specific details.

SCAN Pays $323.7M To Settle Suit

Overpayments For Dual-Eligible Care Alleged
Long Beach-based Medicare Advantage insurer SCAN Health Plan has agreed to pay $323.7 million to state and federal regulators to settle claims of overpayments for care provided to dualeligible seniors. The settlement is the largest ever involving overpayments for dual-eligibles, who are simultaneously enrolled in the Medicare and Medi-Cal programs. The overpayments occurred between 2001 and 2008. According to a statement issued by SCAN, the state of California mistakenly calculated payment rates for dual-eligible care during that period. We played no role in how the state set rates for the population at issue, and we were previously unaware of the mistake the state made, SCAN Chief Executive Officer Chris Wing said in the statement. Once we learned that the State made errors, we decided to refund all the money mistakenly paid. This is the right thing to do and is in the best interests of the thousands of senior citizens we serve. However, state and federal regulators claimed SCAN did not provide the appropriate financial information in order for it to properly set payment rates, and may have infiated the risk scores of its dual-eligible enrollees to obtain higher payments. This settlement is a victory for the Medi- Cal beneficiaries we serve, said Toby Douglas, director of the Department of Health Care Services, which administers the Medi- Cal program. Much of SCANs settlement $320 million is to settle the Medi-Cal portion of overpayments. It will be split between the state and the federal government. The remainder of the settlement, about $3.8 million, covers overpayments from the Medicare program. The settlements stem from a 2009 federal whistleblower suit filed by a former SCAN consultant. He claimed the plan was closely analyzing patient data and systematically upcoding the medical conditions of its enrollees. In settling the claims, SCAN did not admit any wrongdoing. It has about 120,000 Medicare Advantage enrollees in California.
The Payers & Providers California Edition is published every Thursday with six pages of hard-hitting healthcare business and policy news and insights

Rideout Health Rebrands

Rideout Health is the resulting name after a rebranding effort by the former Fremont-Rideout Health Group, which operates hospitals in the Northern California towns of Marysville and Yuba City. Rideout, the surname of the systems original founder more than a century ago, was the preferred choice after the system conducted several stakeholder surveys in 2011. We were gratified to see how important the Rideout legacy is to the community, said Rideout Health Chief Executive Officer Terri Hamilton. The name keeps us rooted in our history and mission, while the streamlined brand is more easily paired with both clinical and business partners to expand healthcare resources for our patients. The rebranding comes as Rideout Memorial Hospital in Marysville is in the midst of a $225 million expansion and renovation.

2012, by Payers & Providers Publishing LLC and MCOL. All rights reserved

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In Brief
Michigan Researchers Caution Against Tight Insulin Control
University of Michigan researchers have concluded that controlling the blood sugar levels of pediatric patients undergoing cardiac surgery does not improve outcomes. The study demonstrates that children do not enjoy the same benefits adult cardiac patients do when their blood sugar is closely monitored and controlled. Overall, 980 pediatric cardiac patients undergoing cardiac bypass procedures ranging in age from newborn to 3 years were closely examined. It was the largest clinical trial ever involving cardiac pediatric patients. This study seems to indicate that tight glycemic control should not be standard practice in pediatric intensive care units for children who have had cardiac surgery, said Michael G. Gaies, M.D., a senior physician at the universitys C.S. Mott Childrens Hospital and the studys lead investigator. We will continue investigating new approaches to improve both short-term recovery and longer-term outcomes for children who need cardiac surgery.

Page 7 MARKETPLACE/EMPLOYMENT Page 5 MIDWEST HealthPartners, Park Nicollet Merge

Deal Will Create $5 Billion Giant In Upper Midwest
Two of the Midwests most prominent healthcare systems announced last week they would merge, creating a multi-hospital system operating in two states. The merger of HealthPartners and Park Nicollet, both located in the Minneapolis suburbs of Bloomington and St. Louis Park, is expected to cut costs for both the organizations. Officials with both HealthPartners and Park Nicollet say they merged organizations will focus on reducing patient readmissions, cutting patient infection rates, and expand the use of electronic medical records in order to eliminate duplicative care. The transaction is expected to create opportunities for growth, through shared knowledge, care redesign efforts, pooled resources and investments and other advantages, said Jeremiah Whitten, director of media relations for Park Nicollet. However, Whitten noted that the groups wont begin looking at concrete opportunities until the agreement is effective, likely in early 2013 pending regulatory approvals. Combined, the two providers will have revenue of nearly $5 billion a year and operate five hospitals, including two in Wisconsin. They will also operate a 1,500- physician medical group and a health plan with 1.4 million lives. In many ways, weve shown whats possible when healthcare organizations work together to put people first. By combining our organizations, well take that collaborative spirit much further, creating new potential for meeting the changing needs of our community at this important time in healthcare, said David Abelson, M.D., Park Nicollets chief executive officer. Under the merger plans, the combined entity would operate under the HealthPartners name, which is much more broadly recognized in the Midwest. HealthPartners CEO Mary Brainerd will retain that position over the two organizations. Abelson will oversee the medical group component of HealthPartners, which will be called the Park Nicollet HealthPartners Care Group. The merger would place the combined entity among the top 10 largest employers in the state, according to the Minneapolis/St. Paul Business Journal. The transaction strengthens Park Nicollet so it will hold up against other large providers in the region. No layoffs are expected to be held after the merger. And patients and members will continue to receive services from their provider and health plan without interruption. The new organization will include medical and dental clinics, Park Nicollet Methodist Hospital in St. Louis Park, Regions Hospital in St. Paul, Lakeview Hospital in Stillwater, Minn., Hudson Hospital in Hudson, Wis. and Westfields Hospital in New Richmond, Wis.

HCSC, Lung Association Work On Asthma Initiative

The Health Care Services Corp. has teamed with the American Lung Association of the Upper Midwest to improve asthma care to children in Illinois and the Southwest. The Chicago-based HCSC operates Blues plans in Illinois, New Mexico, Oklahoma and Texas. It will work with the ALAUM to provide more coordinated care to 480,000 children with asthma, primarily through training at community clinics that treat at-risk children. The training will be provided via HCSCs Healthy Kids, Healthy Families initiative, which aims to improve the health of 1 million kids. Public health experts, schools, and healthcare providers recognize that poorly managed childhood asthma is a pressing public health and social problem, said Paul Handel, M.D., HCSCs chief medical officer. We are dedicated to addressing this devastating diseasewe believe that education is the key to managing asthma.

Abrupt Resignation at Anthonys Memorial Hospital

Dan Woods resigned abruptly as chief executive officer of St. Anthonys Memorial Hospital in central Illinois. Woods, who had served as CEO for 12 years, announced his resignation at a staff meeting late last week. A hospital spokesperson said Woods decision to resign took hospital personnel by surprise. The 146-bed St. Anthonys, which is based in Effingham, is part of the Springfield-based Hospitals Sisters Health System. In a prepared statement, Woods said he and his wife had been considering his stepping down for a significant length of time. However, he did not give a specific reason for his departure. Mark Reifsteck, manager of Sisters Southern Illinois division, has been appointed interim CEO. The hospital spokesperson said it would take about six months to recruit and hire a permanent replacement.
The Payers & Providers Midwest Edition is published every Tuesday with six pages of hard-hitting healthcare business and policy news and insights

Illinois Hospital CEO Resigns

2012, by Payers & Providers Publishing LLC and MCOL. All rights reserved

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MARKETPLACE/EMPLOYMENT WEBINARS WHITE PAPERS

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Recent and Upcoming Webinar Events

CD-ROMs with full audio recordings and presentation slides from all recent HealthcareWebSummit events cosponsored by Payers & Providers are available, and attendee registrations are accepted for all upcoming events. To order a CD-ROM or register to attend any of the following recent or upcoming events, call 209.577.4888 or go to www.healthwebsummit.com The California Healthcare Exchange: A Progress Report August 15, 2012 with David Panush, Director of Government Relations, California Health Benefits Exchange, Anthony Wright, Executive Director, Health Access and Jon Gabel, Senior Fellow, NORC at the University of Chicago Hospital Value Based Purchasing: A Roadmap June 27, 2012 with Robert A. Minkin, Senior Vice President, The Camden Group, Guy DAndrea, President, Discern, LLC, Jason Lee, Senior Manager, ECG Management Consultants Patient Finance: Issues and Pathways June 13, 2012 with Mitch Patridge, Chief Executive Officer, CSI Financial Services, Ron Shinkman, Publisher, Payers & Providers, and Rick Tsupros, President, Match Point Solutions Hospital Districts: Mapping the Future May 24, 2012 with Michael A. Dowell, Partner, Hinshaw & Culbertson LLP, Walter Kopp, President, Medical Management Services, Inc. and Cleo E. Burtley, Manager, The Camden Group Claims Processing: A Collaborative Effort April 26, 2012 with Kenny Deng, Senior Director of Provider Services and Operations, Blue Shield of California, George H. Mack, Vice President, Payer/Provider Relations, and Vice President, Member Relations, Hospital Association of Southern California, and Dan Martinez, Director of Patient Financial Services, Mission Hospital Reducing Readmissions: Collateral Effects April 11, 2012 with Daniel C. Cusator, M.D., Vice President The Camden Group and Maria Lopes, M.D., Chief Medical Officer, AMC Health Managing an Increasing Trend of Elective Preterm Deliveries February 24, 2012 with Larry Boress, President & CEO at Midwest Business Group on Health, Harold Miller, Executive Director, Center for Healthcare, Quality and Payment Reform, and Peter Weeks, M.D., Chairman, Department of Obstetrics & Gynecology at Edward Hospital Charity Care & Community Benefits: The New Paradigm February 16, 2012 with Ronald Sorensen, Director of Community Partnerships at Providence Health and Services Hospital C-Suite Compensation: How Much is Too Much? January 20th, 2012 with Claudia Wyatt-Johnson, CoFounder, Partners in Performance, Ron Shinkman, Publisher, Payers & Providers and Mike Rosenbaum, Partner and Vice Chair of Employee Benefits and Executive Compensation Practice Group, Drinker Biddle & Reath LLP

On May 30, 2012 Payers & Providers released a special white paper, The Many Stories of One Litigious Physician. It is about a prominent surgeons decision to sue the patients she treated at hospital emergency rooms. Many had suffered serious injuries. She sued even if these patients and their families had insurance. She sued even after regulators ordered her to stop. This white paper raises significant questions regarding the payment levels specialist physicians receive to be on call, the role hospitals play in supervising their medical staffs, and the consumer protections available to patients. The Many Stories of One Litigious Physician is available in pdf format for $149. This white paper is the product of months of reporting. It might be the single most significant piece of journalism Payers & Providers has published. To order, call 209.577.4888 or go to www.healthexecstore.com

The Payers & Providers white paper, Follow The Money: Healthcare and Campaign Finance in California, discusses and analyzes the influence of the sectors money on politics and policy. It traces the biggest healthcare industry contributors to candidates and political action committees, how much theyre giving, and where that money is going. Follow the Money is available for $149. In addition to this concise and in-depth investigation, two databases in an easyto-read Excel spreadsheet format are also available for purchase for $129, or with the white paper for $199. They include: All healthcare-related organizations and the itemized contributions they made to candidates and PACs for the 2009-2010 campaign season. Details on more than 90 organizations and big individual contributors are included. A database of the largest donations made by individual employees of Californias hospitals, insurance plans and other healthcare organizations. Details on more than 200 entities are included. Both databases are available in an easy-to-read Excel spreadsheet format.

Given the ramifications of the landmark U.S. Supreme Court Citizens United case, you and your organization simply cannot lack a roadmap to where the political money flows from the healthcare industry in California. To order, call 209.577.4888 or go to www.healthexecstore.com

2012, by Payers & Providers Publishing LLC and MCOL. All rights reserved

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MARKETPLACE/EMPLOYMENT MARKETPLACE

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Employment
The following employment opportunities are listed in the Payers & Providers MCOL Employment Marketplace online at www.mcol.com/emp.htm Director Operations, Managed Care - Oklahoma City, OK System Vice President, Managed Care Strategy and Development - Springfield, IL Health Information Technology (HIT) Program Manager - Los Angeles, CA eConsult Project Manager - Los Angeles, CA The Payers & Providers MCOL Employment Marketplace provides three solutions for employers and recruitment firms to promote employment opportunities to the MCOL and Payers & Providers audience: 1. Payers & Providers Display Ads - that prominently feature your opportunity in the California, Midwest and or National Editions of Payers & Providers. 2. Payers & Providers Marketplace Ads - economically provide readers detailed information on your opportunity in any editions of Payers & Providers. 3. Online Advertising - with a package including web site listings of your opportunity in mcol.com and PayersandProviders.com, plus inclusion of your listing in the monthly edition of MCOL's @Career enewsletter, and eligibility to post the announcement in MCOL's member LinkedIn group. All Payers & Providers Display Advertising, plus qualifying Payers & Providers Marketplace ads receive the online advertising package at no additional cost. Call 209.577.4888 or go to www.mcol.com/aboutcls.htm to request an Employment Advertising Kit, post an employment opportunity or obtain additional information.
Volume 2, Issue 9
Payors & Providers Natinal Edition is published monthly by Payers & Providers Publishing, LLC. Inquiries may be directed to: Phone: (877) 248-2360 e-mail: info@payersandproviders.com Postal: 818 N. Hollywood Way, Suite B, Burbank CA 91505 Web: www.payersandproviders.com Facebook: http://www.facebook.com/Payers-Providers Twitter: www.twitter.com/payersproviders Editorial Board Members: California Edition: Steven T. Valentine, President, The Camden Group; Ross Goldberg, Immediate Past President, Los Robles Hospital and Medical Center; Mark Finucone, Managing Director, Alvarez & Marsol; Henry Loubet, Chief Strategy Officer, Keenan; Anthony Wright, Executive Director, Health Access California Midwest Edition: William M. Dwyer, Healthcare Strategist, Jay Warden, Senior Vice President, , The Camden Group, Ross A. Slotten, M.D., Klein Slotten & French, Michael L. Millenson, President, Health Quality Advisors LLC, Publisher /Editor: Ron Shinkman publisher@payersandproviders.com

Advertising Opportunities
Payers & Providers, publishes the weekly California and Midwest Editions in electronic format and the monthly National Edition in print and electronic format, and serves as the superior source for healthcare business and policy news and insights. Available advertising solutions through these publications include: Dedicated e-blasts to applicable Payer&Providers distribution lists Sponsor messages in each cover email of any Edition Display Advertising inside each Edition Inquire about Sponsored white paper and webinar opportunities To request a 2012 Payers & Providers Media Kit or other detailed Advertising information, please call 209.577.4888.

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Payers & Providers is the premier publication covering healthcare business and policy news in California, the Midwest and Nationally. Each issue of the weekly California and Midwest Editions includes feature articles, Editorials, News Briefs and more, all dedicated to payer and provider news of direct interest to stakeholders. Paid Subscriptions are available for $99 annually for individuals or $149 in bulk for up to ten subscribers. Payer and Provider California or Midwest Edition Paid Subscriptions receive the applicable weekly Edition via email notification listing issue highlights, with links to two viewing options for each issue (direct pdf download, and online viewing). Along with the following additional benefits: Exclusive access to an online archive of past applicable Editions A copy at no additional cost of upcomingl Payers & Providers Quarterly White Papers for that Edition (typically valued at $149 per edition)* Complimentary attendance to Payers & Providers sponsored Healthcare Web Summit event each December: Healthcare Trends (a $225 value) 50% discount on registrations with other Payers & Providers co-sponsored Healthcare Web Summit events Complimentary electronic subscription to Payers and Provider National Edition (a $99 value)
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