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Pinpointing the Right Time to Ask for Referrals (and How to Do It)

Posted by www.psmbrokerage.com Admin on Thu, Jul 30, 2015 @ 09:19 AM

Being excellent at what you do helps you attract new clients, but there’s a lot that you can and should be doing to set yourself up for referrals

It’s no secret that as a business you need to stay top-of-mind with your clients so that they can give you that sweet repeat business and even sweeter referral business — truly the gift that keeps on giving. Being excellent at what you do helps you attract new clients, but there’s a lot that you can and should be doing to set yourself up for referrals. Getting the ask or the timing wrong can mean losing your chance, so having a plan is essential.

Most business owners realize that referrals are critical to their bottom line. Adweek.com shared a survey that found that for B2B brands, referrals converted two times better than websites or social media. A Nielsen study found that 92 percent of consumers around the world say they trust earned media, such as word-of-mouth and recommendations from friends and family, above all other forms of advertising — an increase of 18 percent since 2007.

It’s no wonder experts say that referrals can be more beneficial to your success than advertising. Easier said than done, you say? We get it. We’ve all been there. You ask a client for referrals only to get an empty promise to follow up, or even a straight-up no. But know this: you are in control of the process and results of your referral ask.

Before you can ask for referrals, you must realize how important referrals are to your business, then commit to prioritizing them. Put the work in so that you can maximize your results; you’ll be glad you did.

Referrals don’t just happen.

Asking customers for referrals must become part of your routine. It must be a consistent business practice that becomes a natural part of your daily work. But before you make your first referral ask, you need to develop a strategy.

Author, trainer and former financial adviser Frank Maselli says many people use archaic techniques or just awkwardly ask clients for names. Instead, Maselli recommends changing the conversation and reframing your ask so you don’t sound like you’re requesting a favor. David Finkel, author of “Scale: 7 Proven Principles to Grow Your Business and Get Your Life Back,” says when most businesses talk about referrals, they are referring to word-of-mouth referrals, or what he calls “passive referrals.” Instead, Finkel recommends an active referral strategy.

Before you get started, take a look at a few of the popular resources we’ve created for what to do (and not do) when asking for referrals:

The first step in developing your strategy is to decide which type of referrals are best for your business by assessing what has and hasn’t worked for you and similar businesses in the past. There are three types of referrals:

  • Traditional word-of-mouth referrals
  • Testimonials
  • Online recommendations and reviews

 Keep in mind that word-of-mouth referrals are great, but for many industries, the power of an online referral can be more visual and permanent. Remember that 88 percent of consumers trust online reviews as much as personal recommendations.

 You will, of course, need to customize your strategy to your business’ specific requirements, but it’s helpful to begin with some best business practices in mind. Joanne Black, author of “Pick Up the Damn Phone,” offers the following advice:

  1. Understand what you are asking.
  2. Earn trust first.
  3. Be specific about what you need.
  4. Ask for action, not a contact.
  5. Get a commitment for a confirmation.
  6. Immediately thank your source.
  7. Follow up on the referral.
  8. Thank your source again.
  9. If you make a sale, thank your source again.

Timing is key.

There are no absolutes when it comes to timing except this one thing: your customer must be completely satisfied with your services or product. There are no referrals without happy customers. Asking an unhappy customer for a referral isn’t just a waste of time — it could further damage your reputation with them and their networks.

Getting the timing right can be tricky. Asking too early can make a bad impression, and asking too late can mean your request gets ignored. Experts say that the right time to ask for referrals varies by industry. The Small Business Administration advises business owners to: “Ask for referrals at a time when the customer is in a mood to give them.” While that’s true, it varies a bit from customer to customer. You want to be sure your customer is in a good mood, so catch them at a point when they’re satisfied with your service and are not in the throes of buyer’s remorse.

Ray Sliverstein calls referrals “the number-one tool in your tool kit. “Get in the habit of reaching for it often–say, as often as you might glance at your watch.” Silverstein advises businesses to follow up after the transaction with a thank you and a question: “Do you know anyone else who can benefit from my services?” Silverstein also recommends that when you begin working with a new customer, bring up referrals early. You could mention that you have a profile on Yelp, for example, or give the customer a few extra business cards to give to friends who might need your help.

In his Inc.com article, Finkel suggests creating referral systems, including a script that requests referrals at the point of purchase; as soon as the customer makes the purchase, thank them for their business and ask for the names of two people who would also benefit from their service. Another of his ideas is a “gift for your friend” campaign that uses gift certificates for the customer’s friends after the transaction is complete.

Referral strategies vary, but an analysis of the advice experts give shows that the best time to ask for referrals is immediately after your successful transaction with them is complete.

For a real estate agent, this could mean getting permission from your client for a Facebook post of a congratulatory photo of you at closing on your new dream home. This way, all of the client’s friends and their friends see your success, and those who need your service can easily find you.

For more transactional businesses, like HVAC repair, plumbers, salons, spas, etc., offering a small discount for a quick Yelp or Google review before a customer pays would be an easy way to get the word out to people who are searching for your service — and reputation — online.

Obtain a referral in 3 easy steps.

Here is how the experts say you get it done, step-by-step: 

Step 1: Do your homework. Determine what has worked for your business and others like yours. You could ask your client for referrals before or after you complete your work. You could send an email immediately after your transaction including an easy way to post a review on a social media site or other website.

Step 2:  Deliver exceptional service, ensuring that your customer is happy — so happy that they will share their love for you with their friends.

Step 3: The moment a customer compliments you, accept the compliment and thank them, then make your referral ask. Be polite and direct. Make it easy for them, and thank them for their business — and referrals.

Wrap-Up

Bringing it all together, it’s important to remember a few things about referrals. First, you are the driving force behind your own success. Do good work and be specific about what you want from your clients. Second, time your ask appropriately. Make sure that your job really is done. And lastly, make it a habit. The more you do it, the more natural this process will be in the future.

http://www.outboundengine.com/blog/the-right-time-to-ask-for-referrals/

Source: www.outboundengine.com

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Tags: Referrals, Business, Word-of-Mouth

BREAKING: Anthem to acquire Cigna in $54.2B deal, largest ever in health insurance

Posted by www.psmbrokerage.com Admin on Fri, Jul 24, 2015 @ 08:14 AM

Cigna President and CEO David Cordani, left, will serve as president and chief operating officer of the combined business. Anthem's Joseph Swedish will be chairman and CEO.

Anthem will acquire Cigna for $188 per share, the health insurance companies said Friday. The deal, including Cigna's debt, will be worth $54.2 billion. It is the largest-ever health insurance transaction and part of the mass-scale merger race that is fundamentally changing the industry and fueling concerns over costs and competition.

The definitive agreement comes a little more than a month after Anthem went public with an offer of $184 per share, which Cigna rejected. The two sides had sharp disagreements over who would lead the combined company, which will have $115 billion of revenue, and if Anthem would receive approval from its sponsor, the Blue Cross and Blue Shield Association.

Industry analysts have pointed out several advantages to an industry consolidation.

A larger insurer can gain more leverage and negotiating power to use in hashing out rates with care providers. However, the two mega deals announced this month are going to be scrutinized heavily by regulators, who want to ensure that they do not gain so much power that they can dominate the market.

The impact these big acquisitions have on consumers likely won't be felt for at least a year, because insurers have already finalized most of their plans for coverage that starts in January. A combination may lead to fewer choices and some price changes for consumers, depending on where they live and who already is in their market.

Anthem's combination with Cigna will result in a company with a much broader base over which to spread costs and expenses, and it could make technology investments over the industry's biggest customer pool.

Data and technology are playing a growing role in monitoring patients and care. At a very basic level, that means things like tracking whether patients are keeping up with their immunizations.

Insurers also are trying to give consumers better information on the cost and quality of the care they buy, based on their coverage. Deductibles and other out-of-pocket costs have been rising for years. That leaves a growing number of consumers with bigger bills to pay before most of their insurance coverage starts, so it can encourage more to shop around.

Anthem officials have noted that a Cigna deal will help build their company's Medicare Advantage enrollment in states like Texas and Florida. Medicare Advantage plans are privately run, fast-growing versions of the federally-funded program for people over age 65 and the disabled.

Anthem, based in Indianapolis, is currently the nation's second-largesthealth insurer, while Cigna ranks fourth in terms of enrollment. Anthem Inc. specializes in selling individual coverage and insurance to workers of small businesses. It also has grown its government business, which includes Medicare, Medicaid and coverage of federal employees.

Health insurance is Cigna Corp.'s main business, but it also sells group disability and life coverage in the U.S., and it has a growing international segment that Anthem lacks. Much of Cigna's health insurance business involves coverage where the employer pays the claims and then hires Cigna to administer the plan, a growing and less-profitable form of coverage in employer-sponsored health care.

The deal is targeted to close in the second half of 2016. Cigna stockholders still need to approve the agreement, and Anthem shareholders need to approve the issuance of shares in the transaction.

Anthem stockholders will own about 67 percent of the combined company, with Cigna shareholders owning approximately 33 percent.

The Anthem board will expand to 14 members. Cigna's President and CEO David Cordani and for independent directors from Cigna's current board will join the nine current members of Anthem's board.

Cordani will serve as president and chief operating officer of the combined business, with Anthem's Joseph Swedish as chairman and CEO.

The Associated Press contributed to this story.

http://www.modernhealthcare.com/article/20150724/NEWS/150729899?utm_source=modernhealthcare&utm_medium=email&utm_content=20150724-NEWS-150729899&utm_campaign=mh-alert

Source: www.modernhealthcare.com

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Tags: medicare mergers,, Company News, Markets, Breaking News

The Daily Habits of 20 Highly Successful People

Posted by www.psmbrokerage.com Admin on Fri, Jul 17, 2015 @ 08:17 AM

While the definition of success may be debatable, most people would agree that the leaders of companies getting good traction have likely garnered some measure of it. Want to know how high achievers get to the top? Here are quotes from 20 founders and CEOs on the daily habits that help them get more out of business and life.

1. Prioritize a daily to-do list.

I've got a running task list called "near-term," which contains things that I want to get done during the next one to two weeks. Every morning over coffee, I pull from that list to build a task list called "today." I make a commitment in the morning to clear this and make sure to deliver at the end of each day.

--Sean Duffy, CEO of Omada Health, a digital-therapeutics company that was selected by Fast Company as one of "The World's 50 Most Innovative Companies."

2. Remember names.

Not just staff members but also their spouses, kids, and even pets, if appropriate. Obviously I don't interrogate people for these names, but as they come up in conversation, I try to make a mental note. It helps me to get to know my team...and your team [notices] that you are actually paying attention.... There are several tricks you can do to try to remember someone's name. I always repeat the name when I hear it and then say it a few times over in my head.

--Jonathan Cogley, CEO and founder of IT security company Thycotic which ranks at the 2,671 on the Inc. 5000 list of the fastest growing companies in 2014, up 760 spots from 2013.

3. Research people before meeting with them.

Before a meeting, I always do research on whom I'll be meeting with. Understanding the person's work history, the school they went to, or even knowing their hometown helps me tailor the way I communicate with them.

--Mike Zivin, cofounder and CEO of Whittl, an online appointment booking platform for neighborhood businesses, which recently raised a $3.3 million series A round with backing from GrubHub co-founder Mike Evans as well as GrubHub's first VC, Origin Ventures in Chicago.

4. Schedule family time.

Most small-business owners and entrepreneurs start a business to make a better life for their families. If you get caught in the trap of working 20-hour days, your business may thrive, but at what cost? You may be able to send your kids to a great college, but if they've never spent an afternoon with you in 18 years, is it worth it? I'm very conscious of making time for my kids, whether that means working with them (my oldest is interning in the office this summer) or carving time out to go to tournaments and games. It's easy to get caught up in the day-to-day, but it's so important to step back and look at the big picture.

--Ted Devine, CEO of online small- and microbusiness insurance agent Insureon, a company at the 107 spot on last year's Inc. 5000 list.

5. Walk while working.

Part of being a successful executive is being able to interact with people at a moment's notice, which requires a fair amount of stamina. To achieve that, I work at a treadmill desk all day, and end up walking about eight miles each day.

--Douglas Merrill, former CIO of Google and now CEO of ZestFinance, a big-data startup that uses more than 100,000 data points about an individual to figure out if he or she will pay back a loan.

6. Avoid all habits.

I think having randomness in my day is critical and keeps my brain active. I see too many people whose habits ultimately stifle them. They won't try something new because it conflicts with something they've always done. When I feel I'm falling into a rut, I try to find a way to change things up. That's one of the reasons I travel so much. Of course, it gets me in front of clients, which is critical, but as much as anything, always being in new environments keeps my mind sharp and my thoughts flowing.

--Rodney Williams, cofounder and CEO of LISNR, a new communications technology company that sends data over sound waves (such as streaming video) and recently won the Gold Cannes Lion for Innovation in Mobile.

7. Purge your email inbox.

I get my email inbox to one page by day's end. My job is to communicate and build relationships with clients, prospects, and employees, and all email is dealt with, responded to, or filed as complete. It only stays in the inbox if it needs further follow-up. People need to know they can get response from me, not just the other way around.

--Darin LeGrange, CEO of Aldera, a company that provides health plans (insurers) with the back-office technology that handles billing, claims processing, coverages, and more.

8. Avoid all carbs before noon.

That's my peak energy time, and too many carbs throw me off my game. The momentum created in the morning goes a long way into the afternoon. If you don't start strong, you don't finish strong.

--David Kalt, founder and CEO of Reverb, a marketplace for musical instruments and gear that has raised about $5 million in funding and expects to do $130 million in transactions this year, up from $40 million last year.

9. Don't dive right into work in the morning.

Without fail, I start every morning off with a cup of "proper English tea," even when traveling in San Francisco, and leisurely check the daily newspaper headlines on my tablet, before diving into email and catching up on the company Chatter feed. Having a slower-paced morning routine helps me work more efficiently as the day goes on.

--Jeremy Roche, CEO of FinancialForce.com, an ERP solutions provider built on the Salesforce1 Platform which equips customer-centric businesses with a unified cloud platform and all the applications necessary to grow both the top and bottom line.

10. Make small but meaningful personal statements.

After the ritual coffee every morning, I make sure I have a clean pair of crazy socks. No crazy socks, no glory. They anchor my confidence and remind me that different is good. Everyone could use a personal statement.

--Ahmed Albaiti, founder and CEO of Medullan, a digital health innovation company that works with payers, providers, and pharma on patient engagement.

11. Quantify your life.

There are 8,760 hours in a year, and I know exactly how many of them I have spent working, with family, exercising, or on community activities. For the last 15 years, I have kept a matrix of how I spend each hour in the day in an effort to live a balanced and optimized life. I've had nine major surgeries as part of a lifelong battle with Crohn's disease, so tracking my time and health is essential to helping me maximize every moment. It's also provided the perspective of both a patient and an executive to my companies.

--Jeff Margolis, chairman and CEO of Welltok, creator of CafWell, the health optimization platform that helps consumers achieve optimal health. Previously, he founded the health IT company TriZetto, and took it from startup, through IPO, to a $1.4 billion leveraged buyout.

12. Pay attention to people, not devices.

Put the cell phones away. I try to keep them out of sight when I'm around my kids and in all executive meetings.

--Rick Morrison, CEO of Comprehend Systems, which works with big names in the life-sciences industry, such as Boston Scientific, Astellas, and AstraZeneca, modernizing and improving the quality in their clinical process through cloud-based tech.

13. Wake up early and swallow the frog.

Mark Twain was onto something when he suggested you should tackle your most challenging project first thing in the morning. I wake up at 5 a.m. almost every morning, including weekends. My mornings are a time to tackle thought-intensive tasks, or approach projects with a new perspective. I consider 5 to 8 a.m. my power hours, and try to get through one significant undertaking by 8 a.m. every day.

--Neha Sampat, CEO of digital tech solutions provider Built.io, which powers innovation at the intersection of enterprise mobility and the Internet of Things (IoT) for startups and Fortune 500 companies. Sampat also co-founded KurbKarma, was named a "San Francisco Business Times 40 under 40" honoree, as well as one of "50 Women in Tech Dominating Silicon Valley" in 2015.

14. Don't "find" time for family, make time.

As the CEO of a rapidly growing company, it's easy to let the job consume you completely, to the detriment of those closest to you: your family. It's not enough to "find" time to spend with your children, because the job will always find a way to fill every minute. So I make it a priority to spend two hours a day focusing only on my children. It helps me to recharge my batteries, think more creatively, and it also gives me that daily reminder of why I work so hard.

--Ratmir Timashev, CEO of Veeam, a data center backup company founded in 2006 which now employs more than 1,500 employees around the world and brings in hundreds of millions of dollars in revenue, with its sights on reaching $1 billion in revenue in the next five years.

15. Talk constantly with your team.

Team culture is critical in the American service economy. The only way to make sure that your team is working together at an optimal level is to make sure that you talk both formally and informally with your team.

--Vikram Aggarwal, CEO of EnergySage, a solar-marketplace company that recently secured a $1.5 million Series A round of funding and announced a partnership with Green America.

16. Drive your kids to school every day.

Sure, I would love to sleep later than 6 a.m. every day, but that half hour we spend in the car is amazing. I also try not to schedule client or internal meetings at 3 p.m. That's when I have a scheduled conference call with my sons. They get on board the bus from school, and that's our time to chat about the day so far. Finally, in the evenings, from the moment I walk in my home until they go to bed, my phone stays at the front door so they understand that family time is a priority.

--Sandy Rubinstein, CEO of DXagency, an ad-engagement agency with clients that include DirecTV, HBO, MTV, and Whole Foods.

17. Meditate daily.

Twenty minutes upon waking and 20 minutes as soon as I walk in the door at the end of a day helps me maintain a level of mindfulness that enables moment-to-moment awareness. Meditation has strengthened my ability to be open to new possibilities and ideas without attachment to "my way," and has helped foster a level of communication amongst my team that respects and celebrates new ideas, the very thing that inevitably moves business forward.

--Ernie Capobianco, CEO of digital marketing agency Sq1, which serves clients including Michaels, Jiffy Lube, Shell, and Papa Murphy's.

18. Plan for tomorrow.

At the end of each business day, I take some time to regroup and think about the most important items that need to be accomplished the next day, as well as what actions the team needs to take to accomplish those tasks.

--Michael MacDonald, CEO of nutrition and weight-loss company Medifast.

19. Exercise at least five times a week.

I either hit the gym or get 90 minutes on my mountain bike in the morning and start at 6 a.m. At first it was hard, but now I can't go without it. It de-stresses and sets the tone for the entire day.

--Jason van den Brand, co-founder and CEO of online mortgage refinancing startup Lenda, which graduated from Silicon Valley-based 500 Startups last year. Since then, the company raised its first round of funding, has been growing 40 percent month over month since December, and recently passed the $40 million mark in loans financed through the platform.

20. Publicly commend an employee.

I try to give a written compliment to an employee on something they accomplished the previous day that aligns with our company's core values. The written compliment is public to the entire company through a platform we use called HighGround. I think that doing so helps reinforce our company's core values and helps us live our values every day.

--Ethan Austin, founder of the online fundraising website GiveForward, which has raised more than $150 million and hosts 20,000 active fundraisers at any given time.

What daily habits help you achieve more in business and life?

http://www.inc.com/christina-desmarais/the-daily-habits-of-20-highly-successful-people.html

Source: www.inc.com

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Tags: Success Tips, Entrepreneurship, Business

Aetna agrees to buy Humana for $37 billion

Posted by www.psmbrokerage.com Admin on Thu, Jul 09, 2015 @ 02:03 PM

Aetna Inc.

(Bloomberg) -- Aetna Inc. agreed to buy Humana Inc., the second-largest provider of private Medicare insurance, for $37 billion in cash and stock to broaden its health-care coverage.

The transaction values Humana at $230 a share based on yesterday’s closing price for Aetna, the companies said in a statement Friday. That’s 23 percent above Humana’s last close.

The acquisition comes amid a period of consolidation in the industry, with all of the five biggest health insurers looking at deals. Humana’s 3.2 million Medicare Advantage members have made it a target, since more Americans are turning 65 and becoming eligible for the health program for the elderly and its private insurer-run version.

Willis to merge with Towers Watson in $8.7 billion deal

“Medicare Advantage is a coveted space,” Michael Bernstein, a partner at Baird Capital’s U.S. private equity team who focuses on health care, said in an interview before the transaction was announced. “To develop a similar scale in Medicare would take a great deal of work and time, which would be bypassed by making that transaction happen.”

Terms of Deal

Humana shareholders will receive $125 in cash and 0.8375 of an Aetna share for each of Humana’s. Aetna’s shareholders will own about 74 percent of the combined company and Humana’s will own about 26 percent.

The deal is expected to close in the second half of 2016. Aetna’s chief executive officer, Mark Bertolini, will be chairman and CEO of the combined company.

Medicare membership is projected to rise to 68.4 million in 2023, up 26 percent from this year, according to the Centers for Medicare & Medicaid Services. Humana, based in Louisville, Kentucky, covers more than 14 million people through commercial, Medicare and Medicaid plans.

Centene Corp. said Thursday it agreed to buy Health Net Inc. for about $6.3 billion in a deal that creates the biggest private administrator of Medicaid, the federally funded health program for the poor. Cigna Corp. rejected a $47 billion takeover bid from Anthem Inc. last month, saying the offer wasn’t in the best interests of shareholders and Anthem executives weren’t fit to lead a merged insurance giant.

Some of the consolidation talk has been fueled by the Patient Protection and Affordable Care Act. Known as Obamacare, the 2010 law overhauled the U.S. health-care system with new rules that push insurers to look for savings. The law also provides subsidies to help people afford coverage, creating millions of new customers that the companies are racing to capture.

A Supreme Court ruling upholding those subsidies for more than 6 million people has helped clear the path to dealmaking. The 6-3 decision on June 25 in the King v. Burwell case said the U.S. can continue to give people money to help them buy coverage on the federal healthcare.gov website.

Citigroup Inc. and Lazard Ltd. provided financial advice to Aetna, while Davis Polk & Wardwell LLP is acting as legal advisor. Goldman Sachs Group Inc. gave financial advice to Humana and Fried, Frank, Harris, Shriver & Jacobson LLP is its legal advisor.

http://www.lifehealthpro.com/2015/07/03/aetna-agrees-to-buy-humana-for-37-billion

Source: www.lifehealthpro.com

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Tags: Medicare, Company News, Markets

The Do's and Don'ts of Following Up

Posted by www.psmbrokerage.com Admin on Thu, Jun 25, 2015 @ 11:37 AM

blog pic Following up is a key part of any sales job. It's extremely rare that a rep will connect with their prospect on their first attempt, and so they must try again. And again.

But just because this is common sense doesn't mean it's common practice. According to research from InsideSales.com, the median sales outreach persistency rate for inbound leads is a measly one attempt. So much for following up.

Maybe sales reps don't follow up as much as they should simply because they don't see the value. But consider that even if a lead isn't a good fit for your product or service, that contact could still provide a referral to someone who is. For this reason, it's critical to follow up with each and every single person you meet at an event.

The infographic below from CassiusBlue Consulting lists the do's and don'ts of following up after a networking event. While some tips might be akin to reflex -- for instance, connecting on LinkedIn, and personalizing your message -- others are less obvious. Did you know that adding a contact's email address to your marketing list without permission violates the CAN-SPAM act? And forgetting to set a goal for your outreach (an all too common mistake) can result in a squandered opportunity for a referral or meeting.

If you only take one thing away from this graphic, make it this: Following up is central to sales. Just 2% of all sales are made on the first attempt. If you don't persist, you're bound to leave money on the table.






http://blog.hubspot.com/sales/the-dos-and-donts-of-following-up

Source: blog.hubspot.com


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Tags: sales follow-up, following up after the sale, Sales Tips

Insurers Playing a Game of Thrones

Posted by www.psmbrokerage.com Admin on Thu, Jun 18, 2015 @ 05:02 PM

blog pic Big U.S. insurers are courting one another for possible multibillion-dollar deals. How they pair off could have significant implications for the managed-care industry, its individual and corporate customers, and U.S. medical providers.

Each potential target has strengths in different parts of the managed-care puzzle. For Humana Inc., its fast-growing business covering Medicare beneficiaries could be attractive to several suitors. Aetna Inc. has forged relationships with health systems that use its information-technology services, which could benefit rivals. And, Cigna Corp. brings international customers and close ties with employers big and small.

These companies, along with UnitedHealth Group Inc. and Anthem Inc., have been talking to each other about possible deals, with UnitedHealth approaching Aetna, Anthem talking with Cigna, and Humana exploring a sale, The Wall Street Journal has reported.

Analysts expect tie-ups to reduce the field of five big publicly traded insurers to just three players. The final roster’s strengths and geographic sweep could look very different, depending on how the courtships end—and assuming regulators allow any deals the companies manage to strike.

Consumers might be left with fewer choices in some places, and hospitals and doctors could face tough negotiations with powerful health plans over their pay. Related

Heard on the Street: Humana Won’t Get Lost in Merger Shuffle

“Everyone is looking to have a completely broad portfolio,” and will look for deals that supplement any weaknesses said Jack Rowe, former chief executive of Aetna and now a professor at Columbia University. And, Dr. Rowe added, any deal would likely trigger “a domino effect” as other plans looked to beef up, too. Advertisement

A big deal to acquire Humana could forge a powerful new Medicare player, but some would-be buyers would face antitrust challenges—particularly UnitedHealth, which is already the nation’s biggest player in privately managed Medicare, known as Medicare Advantage.

A behemoth among corporate customers would emerge if Anthem locks arms with Cigna. Or, a merger between United and Aetna could create a company with massive market share in many states that might be able to extract deep discounts from medical providers.

A deal for “any one of them is a seismic event in the industry” that could put outsize market power in the hands of one company, said John Gorman, an adviser to managed-care companies, including some of those now in the mix. But, he said, some of the possible tie-ups make more sense than others.

The moves come as insurers’ core business—covering workers on behalf of big companies—flatlines while new opportunities driven by the Affordable Care Act and other changes emerge.

“Employer markets have been flat and they’re declining in terms of the dollars that go in,” said Dan Mendelson, chief executive of the consultancy Avalere Health. “In that world, if you want to grow, you have to go into the high-growth markets,” which include Medicare and other government business, he said.

That is what Humana offers its suitors: The insurer, which has shopped itself to rivals, is the No. 2 player in Medicare Advantage. Enrollment in that program is swelling as aging baby boomers opt for managed care over the traditional program. About one-third of Medicare’s 50 million beneficiaries are now in such private plans—about three million of them with Louisville, Ky.-based Humana.

Any deal for Cigna or Aetna, meanwhile, would forge a major competitor in the employer-plan business that could gain economies of scale and bulk up market share.

Such deals would “help [the companies] on straight discounts and new contracting models,” said Ana Gupte, an analyst for Leerink Partners LLC. Insurers are increasingly experimenting with new ways to pay doctors and hospitals, such as tying reimbursement to the overall quality of care, but such arrangements are only attractive to hospitals when plans cover a large share of patients.

Ms. Gupte said Cigna also offers experience in managing plans for employers that self-insure. Some plans anticipate they can nab a larger share of employers that opt for that model instead of paying premiums to insurers, in order to lower costs and avoid health-law changes.

For employers, any wave of mergers could potentially result in higher premiums or fees, at least in the short term, several experts said. Many companies put contracts out for bid by health insurers every few years.

“If there are fewer players, there are fewer options to look at,” said Steve Wojcik, vice president of public policy for the National Business Group on Health. That could result in employers getting bids from insurers that feature higher prices and “fewer bells and whistles,” he said.

Long-term though, analysts and experts expect customers to realize some of the savings insurers might gain from increasing market share or improving efficiency.

Hospitals and medical providers have rapidly consolidated in recent years—sometimes leading to higher prices—and employers may benefit from a similar wave in the insurance industry if the heftier health plans can tamp down those prices.

“When you’re negotiating against another entity…size helps,” said Paul Fronstin, director of the health-research program at the Employee Benefits Research Institute. “It may be that insurance companies need to get bigger, or there needs to be fewer of them, in order to negotiate bigger discounts from providers.”

That kind of scale, however, might not help smaller customers, especially individuals who buy coverage on their own.

“Usually, fewer competitors means prices will be less advantageous for consumers,” said Gary Claxton, an insurance expert at the Kaiser Family Foundation. “It probably means they’re going to be in a better position to maintain their margins,” he said.






http://www.wsj.com/articles/insurers-playing-a-game-of-thrones-1434497818...

Source: wsj.com


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Tags: Medicare Supplement, medicare mergers,, game of thrones,

How the ACA is Changing Medicare

Posted by www.psmbrokerage.com Admin on Thu, Jun 11, 2015 @ 03:01 PM

blog pic The aims of the Affordable Care Act (ACA) were to increase health insurance coverage for those under age 65, improve the performance of the health care delivery system, and slow cost growth. Less recognized are the provisions of the law that seek to strengthen the Medicare program.

The ACA addresses gaps in Medicare preventive and prescription drug benefits. It initiates ambitious testing of new payment methods to improve the value of care received by beneficiaries and, indirectly, all Americans. And it substantially extends the solvency of the Medicare Health Insurance Trust Fund by slowing the growth of future Medicare outlays.

By moving Medicare away from fee-for-service payment and by holding health care providers accountable for both the quality and total cost of care, certain ACA reforms have the potential to reshape not just the Medicare program but the entire U.S. health care system. For example, the law’s creation of the Center for Medicare and Medicaid Innovation (CMMI) will enable Medicare to test innovative models of provider payment and service delivery and expand those that demonstrate promise to improve beneficiary outcomes and patient experiences of care or lower cost. The projects initiated by the CMMI are just now beginning to produce results; significant work remains to identify and spread successful payment innovations.

The ACA also makes important changes to the Medicare Advantage (MA) program, through which enrollees can choose to receive their Medicare benefits from private plans. Payment rates to MA plans are to be constrained until those plans are on a par with traditional Medicare, though financial rewards are available for plans achieving high performance ratings. These changes are intended to provide incentives for MA plans to improve quality and patients’ health care experiences and encourage beneficiaries to choose plans with higher quality and lower cost.

While these new policies strengthen Medicare, they were not intended to address some of the serious challenges facing Medicare in the future. Without additional changes, the retirement of the post–World War II generation will cause total Medicare outlays to outpace growth in the economy, claim an increasing share of the federal budget, and exceed the revenues currently dedicated to the Medicare program.

As currently configured, Medicare benefits do not adequately address the financial and health care needs of future beneficiaries—particularly the poorest and sickest among them. Traditional Medicare’s benefit design reflects the fragmented nature of health care delivery, with separate hospital, physician, and prescription drug benefits adding to the complexity, administrative cost, and difficulty of coordinating care. The predominantly fee-for-service provider payment system used by traditional Medicare, and by most MA plans, provides no incentive to eliminate duplicative or ineffective care, coordinate care, or substitute lower-cost care alternatives—and in effect penalizes providers who do so. This mismatch between benefits and needs will be an increasing source of concern as families struggle with out-of-pocket costs, serious health conditions, and inadequate options for caring for family members with physical and cognitive functional impairments.

While the ACA’s reforms hold significant potential to make Medicare more viable and successful in the future, Medicare’s long-term fiscal solvency, complexity, and gaps in coverage remain unaddressed. As millions of Americans age into Medicare, federal budgetary pressures will inevitably focus attention on more fundamental reform of the program.

Read the full document here





http://www.commonwealthfund.org/publications/fund-reports/2015/jun/medicare...

Source: commonwealthfund.com

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Tags: Obamacare, Affordable Care Act, medicare changes

Increased MA and PDP Commissions for 2016

Posted by www.psmbrokerage.com Admin on Thu, Jun 04, 2015 @ 05:18 PM

blog pic Great News. CMS has increased the street level Medicare Advantage and PDP commissions for 2016… to the HIGHEST levels ever! View memo

Not in the Medicare Advantage market but are interested in learning more? Request details or visit our list of companies.

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Tags: ma enrollment,, ma commissions,

CVS to buy Omnicare in $12.7 billion deal

Posted by www.psmbrokerage.com Admin on Thu, May 28, 2015 @ 10:00 AM

blog pic (Bloomberg) — CVS Health Corp. (NYSE:CVS), the biggest U.S. retailer of prescription drugs, agreed to acquire nursing-home pharmacy Omnicare Inc. for a total enterprise value of $12.7 billion.

CVS will pay $98 per share in cash, the companies said in a statement on Thursday. Omnicare, with a market value of about $9.2 billion, hired advisers to explore a sale earlier this year. The deal includes about $2.3 billion in debt.

Omnicare delivers drugs and helps senior-living facilities manage residents’ medications. CVS is the nation’s second-largest pharmacy benefits manager, handling drug plans for health insurers and employers. In its most recent quarter, growth in sales from that business far outpaced the company’s retail division.

“CVS Health will significantly expand its ability to dispense prescriptions in assisted living and long term care facilities, serving the senior patient population” with the transaction, it said.

Both companies are big in Medicare Part D, a federal program that subsidizes medicine for retirees, Charles Rhyee, a New York-based analyst for Cowen Group Inc., said in an interview last month. Omnicare also drew interest from industry leader Express Scripts Holding Co., people with knowledge of the matter said last month.

Board approvals

The boards of both CVS and Omnicare approved the transaction, which holders of Omnicare’s common stock must also clear, according to the statement. It’s expected to close, pending regulatory approval, at the end of the year and boost CVS’s adjusted earnings per share by 20 cents next year, CVS said.

Demand for pharmacy services is rising as patients, insurers and companies look for ways to manage costs with drug prices increasing. Pharmacy-services providers are combining to gain a bigger piece of the growing market.

UnitedHealth Group Inc. (NYSE:UNH) said in March that it would buy Catamaran Corp. in a $12.8 billion deal to create a third-place competitor. That deal came on the heels of Rite Aid Corp.’s agreement to buy pharmacy benefits manager EnvisionRx for about $2 billion.

Express Scripts became the biggest pharmacy-benefits management company after purchasing Medco Health Solutions Inc. three years ago for $34 billion including net debt.

Barclays P.L.C. and Evercore Partners Inc. acted as financial advisers and investment bankers to CVS. Sullivan & Cromwell L.L.P. advised the company on legal matters and Dechert L.L.P. on antitrust questions.

Bank of America Merrill Lynch and Centerview Partners were financial advisors to Omnicare, and White & Case L.L.P. its legal counsel.


http://www.lifehealthpro.com/2015/05/21/cvs-to-buy-omnicare-in-127-billion-pharmacy...

Source: lifehealthpro.com

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Tags: cvs buyout,, cvs buys omnicare,, cvs pharmaceutical buyout,, cvs 12 billion dollar deal,

Memorial Day hours and a Big Thanks!

Posted by www.psmbrokerage.com Admin on Thu, May 21, 2015 @ 01:40 PM

blog pic In observance of the Memorial Day Holiday, our office will be closed on Monday May 25th, 2015. We wish you and your family a safe and happy Memorial Day.

We thank the men and women who serve our country today, those that served before and those that made the ultimate sacrifice for our freedoms.


“Our debt to the heroic men and valiant women in the service of our country can never be repaid. They have earned our undying gratitude. America will never forget their sacrifices.” – Harry Truman

 

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Tags: memorial day blog, memorial day, memorial day quote,

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