January 2012

National Edition
In this Issue
1. News
2012 Trends

2012 Trends Predictions from Thought-Leaders

During December and January MCOL and Health Policy Publishing asked thought leaders their predictions on a range of topics for healthcare in 2012. Payers & Providers has compiled their trend forecasts here. Those who were talked to touched on a number of themes and issues which ranged from the evolution and adaptation of changing business models to the impacts of the Patient Protection and Affordable Care Act.

3. Vitals
Data Snapshots from MCOL

4. California
New CMS Rule May Affect DSH UCSF Enters Into Deal With Sanofi Briefs - Sutter, Aetna Reach Terms On New Contract; Kaiser Program For AtRisk Moms Cuts Costs

5. Midwest
Hospitals Seeing More Bad Debt Wellmark Wins 9.3% Increase in Iowa Briefs - HHS Turns Down Kansas Request for MLR Waiver on Individual Policies; Trustmark is Accused of Violating ACA

Vince Kuraitis, Principal, Better Health Technologies, LLC raises the point that in 2012 and beyond healthcare organizations must advance their business model to better fit the changing economy by stating that We recognize that healthcare is still mostly stuck in the Industrial Age and is just beginning to enter the Digital Economy that other sectors have been participating in for the past 15 years.Vince continues on to say that because of this Business models similar to Apple, Google and Amazon will take on new relevance to healthcare.
Another reason organizations will be changing their business models was given by Tom Zajac, President of MEDai Inc., who talked about how the shifting of risk will cause adjustment and how this new process can be navigated. The risk shift beginning to occur between payers, providers and the marketplace will see significant growth throughout the upcoming year(s). As organizations form to take on the entire continuum of care for patients, they will need to change the overall business model -- how to negotiate population coverage, accept and mitigate risk and streamline the care process. This is a new learning process, and without predictive modeling, its equivalent to embarking on a long, never-before-taken journey without a GPS. Focusing specifically on the shift to a value based business model, Ann Robinow, President of Robinow Health Care Consulting, thinks that the transition is the biggest challenge facing accountable care organizations. Surviving the transition from a business model dependent on volume to a value based business model, while investing in processes that actually reduce volume, is the biggest challenge I see for new ACOs. Everyone is seeking a smooth landing, but realistically its going to be a bumpy ride. Success as an ACO requires investment in new processes, new clinical team members, and reductions in the use of many types of services, often the very services that generate the margins needed to invest in new ways to manage patient care. Another issue arising from Accountable Care Organizations as described by William DeMarco, MA, CMC, President & Chief Executive Officer at Pendulum HealthCare Development Corporation and DeMarco & Associates, is their ability as they move forward to find adequate management. We think there is a skill set needed to manage these entities that is not readily available. First of all, we are talking about managing
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6. WebinarsWhitePapers
Recent and Upcoming Events Healthcare and Campaign Finance in California Midwest Non-Profit CEO Compensation

7. Marketplace
Employment Advertising Opportunities Paid Subscriptions

8. Order Form
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Predictions continued

Payers & Providers

MARKETPLACE/EMPLOYMENT NEWS

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not administrating That means physicians or hospitals need to trust this persons management judgment not only to assess and solve problems, but also to manage the evolution of a startup corporation owned and governed by physicians. This is not like administering a clinic or a department in a hospital. This is a hard point to get across, as many physicians want to be part of every decision and micromanage the ACO into the ground. Earning the bonus means changing the pattern of care; and in many cases changing some things drastically is the only pathway to survival. Expanding on the aforementioned accountable care organizations, Doug Hastings, Chair of the Board of Directors at Epstein, Becker & Green discusses the next chapter for this component of the Patient Protection and Affordable Care Act. With the publication of the Medicare Shared Savings Program Final Rule in October, the end of Don Berwicks tenure at CMS in November, and the announcement of Pioneer ACO participants in December, we have reached the end of a chapter in the quest for a more value-based health care system. The next chapter is implementation, and the single greatest challenge will be to show enough progress fast enough. If the goal of this next period of payment and delivery reform is to test multiple models and to achieve reasonably broad participation so that the best practices can be identified and brought to scale, the initial roll out of Medicare ACOs in 2012 signals the real start of this testing period. Henry Loubet, Chief Strategy Officer at Keenan gave attention to another aspect of the Patient Protection and Affordable Care Act besides ACOs, health insurance exchanges. In California, the formation and organization of the Health Benefits Exchange is well underway and other states will look at these efforts as a model. The Exchange will be a market force in the under 100 employee category. We expect that most of the major health plans will choose to participate in the Exchange not only to maximize their market share, but to help bolster the broadest possible participation and minimize adverse selection. If the Exchange is successful in driving lower premium rates, it could also become a mid-size employer alternative. The above mentioned ACOs and HIXs, as well as other new issues are looked at by Dr. Jonathan Weiner, Professor of Health Policy and Management, Director of the PhD Program in Health Services Research and Policy and the Deputy Director of the Health Services Research & Development Center at Johns Hopkins University through the prism of Predictive Modeling. 2012 will likely be a very active and dynamic year for the predictive modeling/risk adjustment field. The theme will be reformation and transformation. The key issues will include getting ready for the health insurance exchanges and their mandated risk adjustment; maximizing the using of PM within accountable care organizations (pioneer or otherwise); figuring out the impact of ICD-10 on the current

and future crop of RA/PM methods; capitalizing on the new sources of digital data in the nations ever-expanding electronic health record infrastructure; and using PM and RA tools any which way we can to try to control our runaway healthcare costs. The runaway healthcare costs Dr. Weiner refers to are focused on by Dr. Russell Robbins, Principal and Senior Clinical Consultant at Mercer, who specifically looks at the challenge of presenting data to help consumers make more cost efficient healthcare decisions. While healthcare costs are never slipping under the radar, the ability to track and manage them more tightly is a big challenge. We have started to see the reemergence of pricing tools that will enable the individual to make more intelligent healthcare cost decisions based on quality and cost. The challenge is still how will the data be collected, presented, and made actionable in order to enable the individual to understand and make informed healthcare decisions. Another area of growing concern is around improving ways of identifying and engaging the highest cost individuals with the highest quality providers. We have seen models and pilot projects in place which aligns these parties together in ways beyond the basic medical home. The success of these pilots has allowed it to expand into other regions. The take away from the many predictions and 2012 trends is that it is going to be a busy and active year in healthcare full of changes and growth. If you are still left wanting more here are ten predictions for 2012 from MCOL President Clive Riddle: Supreme Court Affordable Care Act decision and presidential election will either cause chaos, or be impetus to for those waiting on sidelines to get moving 2. Attempts to dodge the bullets of Automatic Medicare Payment Cuts will consume Providers lobbying resources 3. Significant resources will be allocated towards the holy grail of reducing preventable hospital readmissions 4. Hospital Systems will ramp up physician integration initiatives 5. The shift to Value Based Provider Payments will be in full swing 6. ACO progress will occur in Commercial health plan initiatives 7. Accelerated demise of the small physician practice 8. Retailization of health care will advance more than ever 9. Implications of Consumers further embrace of generics will be far reaching 10. Health Plan M&A Activities will continue to concentrate in government sector 1.

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

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MARKETPLACE/EMPLOYMENT VITALS
LISTS from

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Stress in America
The American Psychological Association released their fifth annual Stress in America report, which in the APA's words, "paints a troubling picture of the impact stress has on the health of the country, especially caregivers and people living with a chronic illness such as obesity or depression." The Stress in America survey was conducted online by Harris Interactive on behalf of APA among 1,226 U.S. residents. Percent Responding as Follows: extreme stress stress has increased over the past year stress has increased over the past 5 years stress has only slight/no impact on physical health stress has only a slight/no impact on mental health doing an excellent/very good job at managing/reducing stress
Source: Stress in America(tm): Our Health at Risk, American Psychological Association, January 2012 http://www.apa.org/news/press/releases/stress/2011/final-2011.pdf

Health Information Exchange Components that Health Executives Felt Would Have a Positive Impact on Their Organization

22% 39% 44% 31% 36% 29%

1. Primary care connectivity - 88% 2. Continuum-of-care - 84% 3. Clinical quality reporting - 74% 4. Patient accessibility - 67% 5. Interoperable IT systems - 66% 6. Medical staff alignment efforts - 59%
Source: Health Information Exchange Study, Assessing the Interest and Value in HIE Participation Published, Beacon Partners, January 2012 http://www.beaconpartners.com/content/beacon-partners-study-findsmost-healthcare-organizations-recognize-benefits-hies-have

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

Healthcare Spending Likely to be Diminished for Years

Fitch believes the slowdown in the rate of increase in healthcare spending in the U.S. is likely to continue even after the end of the current economic downturn. Ongoing changes in the healthcare industry are expected to contribute to the slowdown for years to come. In 2011, U.S. healthcare spending rose only a fraction from the record low recorded in 2010. Spending increased 3.9%, bringing the total size of the U.S. healthcare system to $2.6 trillion, or $8,402 per person, according to the U.S. Centers for Medicare and Medicaid Services.
Source: Fitch Ratings, January 23, 2012, http://www.marketwatch.com/story/fitch-healthcare-spending-likely-tobe-diminished-for-years-2012-01-23

Use of Security Solutions or Procedures to Safeguard Patient Data Contained on Mobile Devices?
MCOLBlog: Health Care Data Predictions for 2012: We dont do anything to protect mobile devices Policies governing the proper use of mobile devices Anti-virus products installed Encryption solutions installed Passwords or keypad locks Other
Sources: Second Annual Benchmark Study on Patient Privacy & Data Security, Ponemon Institute LLC, December 2011 http://www2.idexpertscorp.com/ponemon-study-2011/

49% 46% 25% 23% 21% 12%

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MARKETPLACE/EMPLOYMENT CALIFORNIA

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In Brief
Sutter, Aetna Reach Terms On New Contract
At a time when health plans and providers have been bumping heads regarding ongoing agreements, Sutter Health and Aetna have come to terms on a new two-year contract. Terms of the pact were not disclosed, but both Sutter and Aetna said in a joint statement that Aetna enrollees will receive covered benefits at innetwork rates at all Sutter hospitals. We were able to come to terms on a new agreement that preserves access for our members in Northern California without disruption, said Brendhan Green, Aetnas vice president of network operations for Northern California. The Sacrmento-based Sutter operates 29 hospitals in the region. By contrast, San Francisco-based Blue Shield of California and the University of California hospitals have yet to come to terms on a new contract, driving up costs for plan enrollees who seek care at the UC providers.

New CMS Rule May Affect DSH

Hospital Association Unenthusiastic About Change
The Centers for Medicare and Medicaid Services is seeking a definition of the term uninsured that may affect the pool of disproportionate share payments Californias hospitals receive. The CMS issued a proposed rule last week that would define the "uninsured" to help calculate the disproportionate share hospital (DSH) payment limit. Hospitals could count as uncompensated care the cost of medically necessary services excluded by their insurance coverage, or have exhausted their benefits or are up against lifetime caps for coverage. Hospitals also could include some of the care provided to individuals covered by the Indian Health Service as uncompensated. About 100 hospitals in California qualify for DSH payments, which totaled about $160 million annually in 2006, according to a Government Accountability Office report. That same year, state regulators began merging DSH payments into supplemental non-DSH payments. Given the relatively small amount of DSH payments, the states acute care providers would not expect a significant bump due to any rule changes, according to the California Hospital Association. This proposal is not expected to have an impact on the DSH payments received by hospitals...because of the severe underfunding in the Medi-Cal program, said CHA spokesperson Jan Emerson-Shea.

Kaiser Program For At-Risk Moms Cuts Costs

Kaiser Permanentes intervention program for women at risk for abusing drugs while pregnant could save up to $2 billion a year if implemented nationwide, according to an in-house study. The study of Kaisers Early Start program concluded that it reduces neonatal health conditions and stillbirths. It examined 49,261 pregnant women in Northern California screened for substance abuse and comparing the healthcare costs for women in similar groups. Early Start was linked directly to $5.9 million in savings. Now, were able to show everyone that not only is it the right thing to do, we will save money, said Nancy C. Goler, M.D., a Kaiser obstetrician who practices in Vallejo and was the lead author for the study. This program is a very low technology intervention that has an enormous net cost savings. The studys findings were published in the journal Obstetrics and Gynecology.

$3.1M Pact Will Focus on Expanding Diabetes Care

The University of California at San Francisco has entered into a $3.1 million pact with New Jersey-based pharmaceutical giant Sanofi to jointly focus on diabetes research and develop new therapies to treat the disease. Diabetes has become an epidemic in the United States, with some 19 million Americans diagnosed with the disease, and an estimated 7 million others who have the disease but arent aware of it yet. Moreover, another 79 million Americans exhibit pre-diabetes symptoms. Diabetes care costs the U.S. $116 billion a year, and continues to drive up the costs of treating related ailments in a variety of ways. Sanofi and UCSF will focus on testing of about 100,000 molecules that help to turn off various genes in the human body. The team will also study whether Sanofis stock of compounds are effective in turning those genes on and off. The combined expertise of the university and the company will focus specifically on how to control beta cells, which produce insulin. Theyre destroyed by type one diabetes and their insulin production is hampered by type two diabetes, which usually occurs in adulthood and is often related to the patients weight and eating habits. UCSF is known for its deep understanding of the underlying biology of diabetes, while Sanofi has great expertise in screening compounds, identifying which molecules have potential, and moving them along to develop a new drug, said Matthias Hebrok, director of the UCSF Diabetes Center. Such an endeavor is almost impossible to accomplish in a single academic laboratory. Thus, both partners profit from the expertise of the other group."

UCSF Enters Into Deal With Sanofi

The Payers & Providers California Edition is published every Thursday with six pages of hard-hitting health care business and policy news and insights

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

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MARKETPLACE/EMPLOYMENT MIDWEST

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In Brief
HHS Turns Down Kansas Request for MLR Waiver on Individual Policies
Kansas will not be permitted a waiver to bring the required medical loss ratio on individual insurance policies down below 80%, the federal government ruled last week. The Kansas Department of Insurance had applied for the waiver under a provision of the Affordable Care Act that allows states to assert that their local health insurance market would be destabilized if the rule were enforced. The ACA forces large-group health plans to spend at least 85% of premium revenue on medical care; small-group and individual plans must spend at least 80%, or pay a rebate to customers a year later if they dont spend that much. The Department of Health and Human Services calculated that insurers Coventry, Humana, Time, and Golden Rule might have to pay customer rebates this year, for exceeding the ratio. The federal department found that, contrary to the request by Commissioner Sandy Praeger, the insurance market in Kansas is stable and competitive, and that no insurer would be likely to withdraw from the state because of the ratio.

Workers in Ohio Cant Make Copays, Deductibles

Hospitals in northeastern Ohio are reporting increased expenses related to uncompensated care, according to federal tax filings for 2010. The Cleveland Clinic spent almost $150 million on charity care, a 25% rise from the previous year. At the same time, bad debt, including expenses for patients who might have had insurance but who couldnt cover their copayments and deductibles, went up 49%, reaching $86.2 million. The clinic had $6.2 billion in total revenue that year. Across town at rival University Hospitals, bad debt rose to $16.8 million, up 13%. At Parma General Community General Hospital, charity care rose 52% to $5.4 million, while bad debt went up 77%, hitting $3.6 million. Hospital system spokesmen said that the higher amounts of charity care and bad debt may turn into long-term realities because of changes in the employment market and the structure of health insurance. Many employers are embracing new-style health plans that put more of the onus on the employee or dependent for higher deductibles or copays. Many insurance plans have been thinned out to make premiums more affordable to employers. A typical deductible may be as high as $500 or $1,000, which many families dont have available to pay at the time of service. Further, the generally high rate of unemployment means many patients dont have jobs with insurance, and their savings have been exhausted meeting basic living costs, such as mortgages, food, and gasoline. Southwest General Health Center reported that many patients who have jobs and health insurance get extra help from the hospital because insurance isnt paying all the costs associated with a hospital stay. According to research by the Kaiser Family Foundation, insurance coverage for persons younger than 65 fell dramatically during the recession. In 2007, 63.5% of the nonelderly population, or 166.1 million people, had employer-based coverage. By 2010, only 58.8%, or 156.4 million people, did. The analysis, using Census Bureau data, showed that the drop in coverage was related to the faltering economy.

Hospitals Seeing More Bad Debt

Trustmark is Accused of Violating ACA

The Obama administration has accused Trustmark Life Insurance Co., based in Lake Forest, Ill., of raising health insurance rates above and beyond whats necessary. It told the insurer to rescind the rate hikes or explain why it believes they are justified. A Trustmark spokeswoman said the company disagrees with the federal findings, and blamed the increases on rising medical costs. Under the health reform law, the secretary of Health and Human Services may conduct an annual review of unreasonable increases in premiums. The department has set increases of more than 10% as subject to review. The department said Trustmark was aiming for increases of 13% in five states: Alabama, Arizona, Pennsylvania, Virginia and Wyoming. Trustmark said it is in compliance with the law.

Wellmark Wins 9.3% Increase in Iowa

Regulator Approves Premium Hike for Individuals
Wellmark Blue Cross and Blue Shield, the leading insurer in Iowa, has received a 9.35% increase in allowable individual policy premiums, under a decision by Susan E. Voss, commissioner of the Iowa Insurance Division. In a letter on Dec. 30, 2011, Voss explained the reasoning behind the decision. The state has authority to regulate rate increases as long as it obtains an actuarial report documenting the reasonability of the proposed rate increase. The division also held a public hearing and received public comment from more than 300 consumers. The division conducted its own actuarial study, and engaged an independent actuary also. The independent firm found that a rate increase of 13.3% could be justified by the rise in local medical costs.

The Payers & Providers Midwest Edition is published every Tuesday with six pages of hard-hitting health care business and policy news and insights

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 Managing an Increasing Trend of Elective Preterm Deliveries to be held Friday, February 24, 2012 at 12 PM Central with Larry Boress, President & CEO at Midwest Business Group on Health, Harold Miller, President at Future Strategies, LLC and Peter Weeks, M.D., Chairman, Department of Obstetrics & Gynecology at Edward Hospital Charity Care & Community Benefits: The New Paradigm to be held Thursday, February 16, 2012 at 10 AM Pacific 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 Editor, Fierce HealthFinance and Mike Rosenbaum, Partner and Vice Chair of Employee Benefits and Executive Compensation Practice Group, Drinker Biddle & Reath LLP California's Healthcare Environment: A forecast for 2012 December 15th, 2011 with Steven T. Valentine, President, The Camden Group, Henry R. Loubet, Chief Strategy Officer, Keenan and Jim Lott, Executive Vice President, Hospital Association of Southern California Midwest Healthcare Environment: A Preview for 2012 December 9th, 2011 with Michael L. Millenson, President, Health Quality Advisors LLC, Jay Warden, Senior Vice President, The Camden Group and William M. Dwyer, Founder and President, Dwyer HC Strategies The New Deal: Private Equity's Role in Healthcare M&A November 17, 2011 with Shane Passarelli, Senior Vice President, Healthcare Finance Group and James Unland, President, Health Capital Group Building the Exchanges: Seeking the Right Roadmap October 27, 2011 with Kevin Counihan, President of CHOICE Administrators Exchange Solutions and Mark E. Lutes of Epstein Becker Green Patient Satisfaction, Outcomes And Your Bottom Line September 29th, 2011 with Shannon OKelley, Chief Operating Officer, and J. Eugene Grigsby, Chief Executive Officer, National Health Foundation, UCLA Health System

A new 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

Payers & Providers popular non-profit hospital CEO salary survey is now available the Midwest edition. This voluminous survey will examine the compensation of more than 700 hospital CEOs in 10 states throughout the Midwest. The salary survey is available in two distinct components: The salary survey white paper analyzes the compensation data from the 30,000-foot view. Authored by Payers & Providers Midwest edition editor Duncan Moore, it includes interviews with hospital officials and compensation experts and includes key compensation statistics. This white paper is $149. The raw salary compensation data itself is available in an Excel spreadsheet format. It includes base salary, additional compensation and other key indicators. The data is taken from the 990 tax returns each hospital submits to the Internal Revenue Service. This data may be purchased on its own for $249, purchased in combination with the white paper for $349, or by state for $99 apiece.

The hospital CEO compensation survey is Payers & Providers single most popular product. Its useful for quickly gauging what your colleagues earn and whether your own compensation is in line. 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 Executive Positions, Managed Care Organizations Throughout US Senior Medical Director, Harvard Pilgrim Health Care - Wellesley, MA Vice President of Operations - Austin, TX Chief Medical Officer - Boston, MA 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 1
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: www.facebook.com/payersproviders 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: Brian J. Silverstein, MD, SVP, The Camden Group; Michael A. Millenson, President, Health Quality Advisors 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 health care 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 Order Form

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