Winter 2011

In this Issue:
New Study Finds Lack of Competition Among Health Insurers
Healthcare Fraud News
Physicians to get Relief from Medicare Lab Paperwork Ruld
New Partnership with EMI Health
Explore New Options for Your Clients

AFMC Contact Information

AFMC Senior Sales Consultants:  


Judi Hayer  direct: 602-417-2813
[email protected]

Larry Dennis, RHU


[email protected] 

326 E. Coronado Rd.
Phoenix, AZ 85004


Quick Links

Informational pieces to assist you and your clients....


Urgent Care List 


Convenience Clinics 


How to Customize and Download an AFMC Provider Directory


VentureNet Brochure 

Introducing Single Source! 

AFMC's new partially self-funded and fully-integrated health benefits product.


SingleSource is an alternative to fully insured and traditional self-funded plans that provides affordability, flexibility and customization for employer group benefits. Read more...


Network Updates

The following facilities have been added to the AFMC Network. Unless otherwise stated, all facilities are contracted to participate in all AFMC Network Plans:  



Ultrasound Institute Medical Group  


Home Health 

Arizona Medical Infusion
Cornerstone Healthcare 


Sleep Study 

Valley Oximetry Sleep Disorder Center - Five locations across the Valley


Behavioral Health 

Phoenix Shanti Group  

Southwest Center for HIV/AIDS


Other Updates

St. Joseph's Hospital & Medical Center

has added Pediatric Heart Transplant services to AFMC's contract. 


Tizon Emergency Associates is a new ER group  effective (3/15/11) providing services in Lake Havasu

the Advisor

Arizona Foundation for Medical Care

E-newsletter for Brokers, Consultants and Agents

New Study Finds Lack of Competition Among Health Insurers


The vast majority of commercial health insurance markets in the United States are dominated by one or two health insurers, according to a newly updated analysis released by the American Medical Association.


The 2010 edition of Competition in Health Insurance: A Comprehensive Study of U.S. Markets found that 99 percent of health insurance markets in the U.S. are "highly concentrated", based on the 1997 U.S. Department of Justice and Federal Trade Commission Horizontal Merger Guidelines. This indicates a significant absence of competition among insurers. In 48 percent of metropolitan statistical areas, at least one insurer had a market share of 50 percent or more. Read more....   

Healthcare Fraud News... 


Employers, college admissions officers, and divorce lawyers use social networking sites like Facebook and MySpace to do background checks. Now health insurers are getting into the act. Such sites have become the latest tools for detecting fraud, which the industry says costs the United States as much as $80 billion a year and accounts for 3%-10% of total healthcare spending.


One 30-year-old patient, for example, took a medical leave from her job for major depression. When a representative of her insurer saw photos of her on Facebook frolicking at a beachand hanging out in a pub, she was deemed depression-free and able to work; her payments abruptly stopped.  Click and scroll to read more...    

Physicians to get Relief from Medicare Lab Paperwork Rule 


The AMA and groups representing clinical laboratories had urged CMS to rescind a new requirement that doctors sign off on lab tests.


Responding to pressure from the American Medical Association and others, the Centers for Medicare & Medicaid Services has indicated that it will rescind a new Medicare rule requiring physicians to provide their signatures on requisitions for laboratory tests. Doctors had warned that the rule would have created paperwork headaches for medical professionals ordering and fulfilling lab test requests, ultimately having an adverse impact on patient care.


The signature policy has been on the books since Jan. 1, but it was never enforced by the Medicare agency. CMS finalized the rule in its 2011 physician fee schedule in November 2010. However, citing concerns about lack of awareness of the change in the health care industry, the agency delayed enforcement of the policy until April 1, 2011. Click and scroll to read more....    

New Partnership


Arizona Foundation for Medical Care has signed a partnership with EMI Health (formerly Educators Mutual) to be their network of choice in Arizona for their TPA services.  


EMI Health, formerly Educators Mutual Insurance Association of Utah, is a nonprofit organization, which has been serving the needs of Utah's employers for 75 years by maximizing health benefits while keeping premiums at a minimum. EMI Health offers insurance benefits and services to government and public and higher education groups such as the Utah Transit Authority, Alpine School District and Bountiful City. Plans are underwritten or provided by Educators Mutual Insurance Association of Utah; Educators Health Care; Educators Health Plans Health; and Educators Health Plan Life, Accident and Health.  For more information, visit

Explore New Options for Your Clients

For an easy to manage integrated, self-funded program look no further than VentureNet Healthcare.


VentureNet simplifies the self-funded process by providing one access point for groups, eliminating the need to maintain separate network access in different states.  


Beginning with new client implementation through group renewal, VentureNet members and providers have one contact to answer questions, one claims submission point and one logo. Network Representatives are also available to help employers evaluate the healthcare needs of their workforce and assist with making program adjustments as their needs change.   


VentureNet Healthcare provides the perfect balance between quality service and products for its members. Continue reading to discover how VentureNet's depth and breadth of products and services can provide innovative solutions for employers.

No matter where business may take them or how their needs may change, VentureNet members have access to reliable, cost-effective healthcare networks. Get started.

Arizona Foundation for Medical Care