Health Plan Facts, Trends & Data: 2012-2013

Erin Trompeter and Susan Namovicz-Peat

Published by Atlantic Information Services, Inc. (AIS), 2012
ISBN 10: 1936230399 / ISBN 13: 9781936230396
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Description:

Former Library book. With CD! Shows some signs of wear, and may have some markings on the inside. Bookseller Inventory #

About this title:

Synopsis:

Health Plan Facts, Trends & Data is a one-of-a-kind resource packed with practical information on the important trends that are re-shaping the health care industry. Health Plan Facts, Trends & Data is a convenient source of insight into the challenges of an industry in flux with reliable data, directories & other valuable resources that you can put to work today.

Table of Contents
Ch 1: Health Plan Enrollment Trends & Market Share
*Employer-Sponsored Enrollment Data
*FEHBP, TriCare & Other Federal Programs
Ch 2: Health Plan Organizational Structure & Leadership
*Executive & Board Member Compensation Trends & Developments
*Lobbying & Donations
*Leadership Changes & Appointments
Ch 3: Health Plan Growth & Consolidation
*Mergers, Acquisitions & Divestitures
*Affiliations & Partnerships
*Market Moves, Expansions & Contract Awards
*Overseas Market
*Product Launches & Coverage Expansions
*Uninsured & Underinsured Populations
*Marketing Strategies
*Retail Insurance Outlets
Ch 4: Health Plan Financial Performance
*Costs & Profitability
*2011 & 2012 Annual Results & Projections
*Q2-4 2011 & Q1 2012 Results
*Stock Market Performance
*Key Financial Data
Ch 5: Health Reform Decisions & Impact
Ch 6: MLRs
*Regulations
*Broker Compensation
*Rebates
*State Waivers
*MLRs & MLR Factors for Selected Companies for 2011
*2011 MLRs by Market for 10 Large Health Insurers
Analysis of Components of 2011 MLR Calculations
Ch 7: Rate Setting & Premiums
*Causes of Rate Increases
*Increases, Decreases, Denials & Delays
*Oversight & Regulation of Rate Increases
*Premium Trends
Ch 8: Insurance Exchanges
*Effect of Exchanges on Health Plans & Other Stakeholders
*CO-OPs
*Essential Health Benefits
*Private Insurance Exchanges
*State Exchanges
*HHS Initiatives
Ch 9: Benefit Design
*Design Strategies
*Value-Based Design
*Limited Benefits Plans/Mini-Meds
*HSAs, Debit Cards & Other Financial Products
Ch 10: Employer Strategies & Challenges
*Coverage Costs & Trends
*Benefit Design Strategies
*Defined-Contribution Plans
*Narrow Networks
Ch 11: Pharmacy Strategies for Health Plans & Employers
*PBM Market Moves
*Pharmacy Cost Concerns
*Coupons & Copay Programs
*Pricing Disputes
*Generics Use
*Genetic Testing
*Narrow Pharmacy Networks
*Outcomes-Based Research
*MTM
Ch 12: Provider Network Admin, Reimbursement & Contracting Issues
*Health Information Exchanges
*Affiliations Between Health Plans & Providers
*Quality Initiatives
Ch 13: ACOs
*ACO Pilots & Programs
*Health Plan Participation
*Regulations & Legal Concerns
*Quality Initiatives
Ch 14: Health Promotion, Wellness & Disease Management Strategies & Challenges
*Health Management & Utilization
*Strategies for Specific Health Issues
*Patient-Centered Medical Homes
*Wellness Initiatives
Ch 15: Social Media Tools & Other IT Communications Strategies
*Online & Interactive Tools for Consumers
*Applications for Communications through Mobile Smartphones
*Telemedicine
Ch 16: Records Security, Coding & Data Protection Issues
*Data Management & Claims Processing
*Data Security Challenges & Breaches
*Electronic Health Records
*ICD-10 Compliance
Ch 17: Health Plan Legal Challenges
*False Claims & Fraud & Abuse Issues
*Health Plan Liability & Legal Actions
*'Most Favored Nation' Clauses
*Consumer-Related Violations
*EOB Forms
*Coverage of Same Sex Spouses
*State-Level Legislation
Ch 18: Health Plan Resources & Directories
*Federal & Regional Medicare Regulators
*Health Plan Trade Associations

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Bibliographic Details

Title: Health Plan Facts, Trends & Data: 2012-2013
Publisher: Atlantic Information Services, Inc. (AIS)
Publication Date: 2012
Book Condition: Good
Edition: 17th.

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