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AIS Health Plans MarketplaceScroll down to read short descriptions of AIS's Health Plan products. Newsletters
Listing More Health Plan products are available at the AIS Pharmacy Benefit MarketPlace and the AIS Consumer-Directed Care MarketPlace Print an order form: If you do not wish to place your order online, click here to download a printable order form (PDF file), then submit your order via fax or mail, as directed on the form.
THE AIS REPORT ON BLUE CROSS
AND BLUE SHIELD PLANS, valuable news and penetrating analysis
of new products, market share, strategies, conversions, financing,
profitability and strategic alliances of Blue Cross and Blue Shield
plans. Written by insightful managed care writer/analyst Jill Brown.
(Published independently by AIS. Not affiliated with or sponsored,
endorsed or approved by the BlueCross BlueShield Association or any
of the independent Blue Cross and Blue Shield companies.) 12 issues
annually ($477 per year) or 2-month intro ($72 for 2 issues); both
include print copy and e-mail delivery.
HEALTH PLAN WEEK (formerly Managed Care Week), timely business, financial and regulatory news of the health insurance industry — with the inside news, targeted data and expert analysis that will help
improve your organization's bottom line. Since 1991, this newsletter
has been the industry's most respected and widely read news source.
45 issues annually ($677 per year) or 2-month intro ($91 for 8 issues);
both include print copy and e-mail delivery.
MEDICARE ADVANTAGE NEWS, timely news and strategies to boost revenues, increase enrollees and cut costs in Medicare Advantage and Medicaid managed care. 24 issues annually ($471 per year) or 2-month intro ($69 for 4 issues); both include print copy and e-mail delivery.
AIS’S 2003-2007 HEALTH PLAN ENROLLMENT STATISTICS: COMPARATIVE 5-YEAR MARKET SHARE, TRENDS AND DATA, exclusive data compiled from AIS’s proprietary database. This comprehensive analysis of 5 years’ worth of comparable health plan enrollment data includes national enrollment for all U.S. health insurance companies offering fully insured medical coverage, with state-specific breakdowns and enrollment by product type where available. Includes CD with raw data and a summary report. ($6,235) AIS’s DIRECTORY OF HEALTH
PLANS, the most comprehensive resource available on the U.S. health plan market — more than 500 pages of thoroughly researched and
verified information. It contains the most up-to-date enrollment data
and contact information for health plans and primary care preferred provider networks operating in the U.S. Database also available on CD. ($622)
THE AGING OF AMERICA: IMPLICATIONS FOR THE BUSINESS OF HEALTH CARE is packed with data, trends, projections and other research findings on how Baby Boomers are about to reshape U.S. health care ... with contributions from organizations like The Brookings Institution, First Consulting Group, The Commonwealth Fund, RAND Corp. and The Urban Institute; and government agencies like the Administration on Aging, CDC, Congressional Budget Office, Congressional Research Service, Institute of Medicine, Census Bureau, and Bureau of Labor Statistics. Separate chapters focus on how Boomers will impact hospitals and other providers, health plans, long-term and home care services, age-related diseases, and much more. ($187)
EXPANDING MARKET SHARE: A GUIDE TO BLUES PLAN STRATEGIES AND ALLIANCES is a report on the latest strategies and techniques used by Blue Cross and Blue Shield plans to develop and market insurance products — and how these benefit designs are helping to keep Blues plans among the nation’s most recognized and competitive insurers. It includes details of Blues plans in individual, small-group, middle-market and national accounts; expansion efforts in market segments at state, multi-state and national levels; Blues’ strategies for state health reform efforts; and alliances created to capitalize on federal programs like TRICARE, Medicare and Medicaid. ($84) PDF version also available.
GUIDE TO MEDICARE REFORM LAW: OVERVIEW AND HIGHLIGHTS FOR HEALTH PLANS, HOSPITALS AND PROVIDERS, summaries and explanations of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 — in an easy-to-read format with a detailed table of contents for each of the 12 titles of the Act. ($84)
HEALTH PLANS AND DISEASE MANAGEMENT: THE NEW ENVIRONMENT examines current disease management strategies and programs used by health insurers to improve outcomes and contain costs. The report evaluates programs that target specific diseases and conditions, and gives you a chapter outlining chronic disease programs aimed at Medicare populations. It also reviews the implications of new consumer-directed product designs on disease management programs, and assesses the link between specialty pharmacy and disease management programs. ($69) PDF version also available via e-mail.
HEALTH PLAN FACTS, TRENDS AND DATA, a best-selling annual book brimming with insightful news on important trends that are re-shaping the health care industry, and reliable data, directories and other valuable resources you can put to work today! Written and organized by AIS's experienced health reporting staff. ($398)
HEALTH PLAN PAY-FOR-PERFORMANCE PROGRAMS: THE NEXT GENERATION explores the dramatic change in the scope and depth of pay-for-performance (P4P) programs during the past several years. This book looks at such trends as P4P programs with specialist physicians and PPOs, P4P programs with hospitals and programs geared toward specific diseases, and also contains three case studies from well-respected health insurers. ($124) PDF version also available.
MANAGED MEDICARE AND MEDICAID FACTBOOK, a valuable resource packed with rates, benefit designs, directories, trends and strategies on the Medicare Advantage (MA) program and managed Medicaid. Features coverage of the overhauled Medicare program, including new payment rates, and practical information on the Part D drug benefit, Special Needs Plans, MA private fee-for-service, and much more. Written and organized by AIS's experienced health reporting staff. ($418) CD version also available.
THE NEW SPECTRUM OF BLUES PRODUCTS,
a report on the flow of traditional, consumer-directed, Medicare Advantage
and other products that Blue Cross and Blue Shield plans continue to
bring to their markets. Includes details on how Blues plans have increased
membership through new products for underserved markets, federally funded
programs — including the Medicare Part D drug benefit, and more.
($69) PDF version also available via e-mail.
SPECIAL NEEDS PLANS: MARKET STRATEGIES AND DATA follows the evolution and growth of Medicare Special Needs Plans (SNPs) from their introduction in 2004 to their current boom — and questions about their future. The report features a comprehensive directory of SNPs with enrollment data, plus insight into health plans' decisions to expand their SNP operations, and their subsequent successes or roadblocks — including cost, compliance and marketing strategies. ($69) PDF version available.
Meetings are listed
below in reverse chronological order,
NEW MENTAL HEALTH PARITY LAW: WHAT HEALTH PLANS MUST DO NOW TO COMPLY, a recording of a 90-minute audioconference held on November 19, 2008. Three experts on the new legislation — Rhonda Robinson Beale, M.D., chief medical officer for UnitedHealth Group subsidiary OptumHealth Behavioral Solutions, Kathleen Mahieu, a senior consultant in Hewitt Associates, LLC’s Health and Productivity Solutions group, and John Hickman, Esq., head of Health & Welfare Benefits in the Employee Benefits and Executive Compensation Group at Alston & Bird, LLP in Atlanta — share their strategic insights on specific actions that your organization can take to control costs while ensuring the availability of the newly mandated behavioral health care benefits. ($329)
WHAT AN OBAMA PRESIDENCY WILL MEAN FOR MEDICARE ADVANTAGE AND PART D, a recording and transcript of a 90-minute audioconference held on November 13, 2008. John Gorman, CEO of Gorman Health Group, LLC and one of the industry’s most experienced and knowledgeable MA/Part D observers, will provide you with specific suggestions on how to plan — and position your organization — for what the new Administration and Congress are likely to do on Medicare. ($329)
FINAL MEDICARE MARKETING RULES: THE TIME TO CHANGE AND COMPLY IS NOW!, a recording of a 90-minute audioconference held on October 23, 2008. Gorman Health Group’s managed care marketing and regulatory experts Jeff Fox and Jean LeMasurier detail the steps you should be taking to ensure that your MA and Part D marketing is effective and compliant, both in the upcoming open-enrollment season and beyond. ($329)
HEALTH PLAN STRATEGIES FOR USING PREDICTIVE MODELING IN UNDERWRITING, a recording of a 90-minute audioconference held on August 26, 2008. Hear two experienced health plan executives outline how their companies use predictive modeling tools to improve the accuracy and profitability of underwriting efforts. Speakers are: Swati Abbott, president of MEDai, Inc., and Sharon Howe, director of underwriting for LifeWise Health Plans in Oregon and Arizona, subsidiaries of Premera Blue Cross. ($329)
NEW MEDICARE ADVANTAGE AND PART D MARKETING RULES: KEY STRATEGIES FOR HEALTH PLANS,a CD of a 90-minute audioconference held on June 5, 2008. Find out what steps you need to take to ensure that your Medicare Advantage and Part D marketing is both effective and compliant under the CMS rules released May 8 — from Gorman Health Group’s Jeff Fox and Mary Kaye Thibert. ($329)
IMPLEMENTING ‘MEDICAL HOMES’ TO IMPROVE PATIENT CARE AND THE BOTTOM LINE: STEPS THAT HEALTH PLANS AND PROVIDERS SHOULD TAKE, a CD of a 90-minute audioconference held on May 21, 2008. Two of the nation’s top Medical Home experts — Joe Gifford, M.D., senior medical director of The Regence Group, and Pranav Kothari, M.D., co-founder of Renaissance Health — describe sensible first steps that health plans and providers could take to create, partner with and reward Medical Home practices. ($329)
NEVER-EVENT PAYMENT POLICIES: HOW MAJOR HEALTH PLANS ARE GETTING TOUGH ON PREVENTABLE HOSPITAL ERRORS, a recording of a 90-minute audioconference held on May 13, 2008. Learn how to implement and enforce never-event payment methods — from Charles Cutler, M.D., Aetna’s chief medical director for national accounts, Jay Schukman, M.D., medical director of Anthem Blue Cross Blue Shield of Virginia, and Leah Binder, CEO of The Leapfrog Group. ($329) Available on CD or as an MP3 file.
PERSONAL HEALTH RECORDS (PHRs): NEW STRATEGIES FOR HEALTH PLANS, a CD of a 90-minute audioconference held on April 23, 2008. Learn effective strategies for effectively developing and deploying a PHR to serve the needs of stakeholders — from two of the country’s top PHR experts: Jan Oldenburg, practice leader, health portfolio for the Internet Services Group within Kaiser Permanente, and Scott Heimes, senior vice president of consumer solutions for OptumHealth’s direct-to-consumer efforts. ($329)
THE DEC. 29, 2007 MEDICARE LAW: IMMEDIATE STRATEGIES FOR HEALTH PLANS, a CD of a 90-minute audioconference held on January 29, 2008. Two of the nation’s top Medicare Advantage experts — Gorman Health Group’s John Gorman and Jean LeMasurier — explain what the changes created by the new law actually mean for you and your partners’ product strategies, benefit designs and application filings, and what you should do in light of this. ($329)
HEALTH PLAN STRATEGIES FOR HIGH-TECH IMAGING TESTS, a CD of a 90-minute audioconference held on November 29, 2007. Learn specific steps you can take to address rising costs and formulate coverage polices for advanced and emerging high-tech imaging procedures (MRIs, CT scans and PET scans, CT angiography, functional MRI’s for Alzheimers’s disease) — from Ken Patric, M.D., vice president and chief medical officer at BlueCross BlueShield of Tennessee and Diane Hayes, vice president of research and development for medical technology assessment firm, Hayes, Inc. ($329)
THE RETURN OF MEDICARE LOCAL PPOs: IMPLICATIONS FOR MA PLANS AND MEDIGAP INSURERS, a CD of a 90-minute audioconference held on October 31, 2007. Find out how Medicare plan sponsors and their partners can prepare for, and capitalize on, the market changes likely in 2008 with the re-emergence of local PPOs — from Gorman Health Group’s John Gorman and Tom Anderson. ($322)
UPCOMING PART D AUDITS AND ENFORCEMENT: STRATEGIES FOR PREPARING YOUR PLAN AND PBM, a CD of a 90-minute audioconference held on September 20, 2007. Hear the details of urgent new compliance challenges Part D plans and PBMs face, and learn practical steps you can take to prepare for inevitable CMS audits and aggressive government enforcement — from ATTAC Consulting Group’s Steve Arbaugh and Susan Roberts. ($322)
NEW HEALTH PLAN STRATEGIES FOR DISEASE MANAGEMENT: LESSONS LEARNED FROM THE MEDICARE HEALTH SUPPORT PILOT, a CD of a 90-minute audioconference held on August 21, 2007. Discover how to operate cost-effective DM programs for patients with multiple comorbidities, and the lessons health insurers, DM programs and others can learn from early Medicare pilot results. Speakers are: Christobel Selecky of LifeMasters Supported SelfCare, Inc., Vince Kuraitis of Better Health Technologies, LLC, and Jean Bisio of Green Ribbon Health LLC. ($322)
VALUE-BASED INSURANCE DESIGN STRATEGIES FOR HEALTH PLANS, a CD of a 90-minute audioconference held on April 24, 2007. Mark Fendrick, M.D., co-director of University of Michigan’s Center for Value-Based Insurance Design and Lonny Reisman, M.D., CEO of ActiveHealth Management, Inc. share valuable strategies for implementing the value-based insurance design concept, and overcoming the challenges that can hinder its widespread use. ($322)
MEDICARE PRIVATE-FEE-FOR-SERVICE: HEALTH PLAN STRATEGIES FOR A BOOMING BUT CONTROVERSIAL PRODUCT, a CD of a 90-minute audioconference held on April 19, 2007. Get an inside look at the factors triggering the current PFFS boom and controversies, from two of the nation's top Medicare managed care experts. John Gorman and Jean LeMasurier of Gorman Health Group outline details of strategies that will help you seize the opportunities in PFFS while guarding against the major pitfalls. ($322)
NEW OPPORTUNITIES FOR HEALTH PLANS IN LONG-TERM CARE, a CD of a 90-minute audioconference held on February 8, 2007. Michael Quilty, president and CEO of Matrix Management Services, Holly Michaels Fisher, a senior consultant with Reden & Anders, and Tom Coble, founder and CEO of HealthCare Management Company of Oklahoma (HMC), detail the specifics of the opportunities — and the pitfalls — for health plans in serving long-term care populations. ($322)
NATIONAL PROVIDER IDENTIFIERS: HEALTH PLAN CONTINGENCIES TO AVERT A SPRING DISASTER, a CD of a 90-minute audioconference held on December 13, 2006. Two health plan NPI experts — Chris Apgar, a consultant with Apgar and Associates, and Beth Cox, compliance director for regulatory assurance at WellPoint, Inc. — share effective approaches to making a smooth transition to NPIs, before the May 23 deadline for using new 10-digit NPIs for all standard electronic transactions. ($292)
MEDICARE SPECIAL NEEDS PLANS: STRATEGIES FOR SUCCESS IN 2007 AND BEYOND, a CD of a two-hour audioconference held on November 2, 2006. Two experts from Gorman Health Group — John Gorman, president and CEO, and Rick Bowles, Special Needs Plan Practice leader — provide you with the tools you need to improve patient outcomes and your bottom line in the difficult and increasingly competitive SNP market. ($292)
MEDICARE RISK ADJUSTMENT STRATEGIES: JANUARY DEADLINE
LOOMS TO CORRECT CODING ERRORS, a CD of a two-hour
audioconference held on September 27, 2006. John Gorman, president
and CEO of Gorman Health Group, and David Bach, M.D., CEO of
Leprechaun, will provide "best practices" you can use to
make sure you get the maximum amount of risk-adjusted payments you're
entitled to — and implement effective programs to reduce incorrect
coding so you can thrive in the new Medicare environment. ($292)
MEDICARE PART D DIAGNOSTICS: TROUBLESHOOTING YOUR DRUG PLAN, a CD of a two-hour audioconference held on July 20, 2006. Three experts from Gorman Health Group, LLC — Babette Edgar, Michael Flagstad and Jeff Fox — guide you through an analysis of your Part D operations, enabling you to identify trouble spots in your plan and design effective corrective steps. ($292)
INSURER STRATEGIES FOR THE NEW MEDIGAP MARKET, a CD of a 90-minute audioconference held on June 28, 2006. John Gorman, president and CEO of Gorman Health Group LLC, dispenses reliable how-to advice about what to do to succeed in the rapidly changing Medigap environment. ($292) PREDICTIVE MODELING
IN UNDERWRITING: NEW HEALTH PLAN STRATEGIES,
a CD of a 90-minute audioconference
held on June 7, 2006. Penny Hahn,
the actuarial director at Humana Inc.,
and Diane Laurent, a senior
vice president at DxCG, Inc., discuss
effective strategies for selecting
and using predictive modeling tools
for underwriting. They also share
valuable tips and tactics that can
help plans and their partners make
use of these tools in premium rate-setting,
benefit selection, marketing and sales.
($292)
STRATEGIES
FOR
THE
MAY
15
MEDICARE
PART
D
LOCK-IN,
a
CD
of
a
90-minute
audioconference
held
on
April
20,
2006.
Two
of
the
nation’s
leading
experts
in
Part
D
—
Gorman
Health
Group’s
John
Gorman
and
Jeff
Fox
—
analyze
the
marketing
and
sales
challenges
health
plans
face,
and
offer
advice
on
how
plan
sponsors
can
maintain
and
grow
their
membership
despite
the
lock-in.
($292)
HEALTH PLAN
PAY-FOR-PERFORMANCE RESULTS: RECENT
CLINICAL AND FINANCIAL OUTCOMES,
a CD of a 90-minute audioconference
held on March 16, 2006. Jeff Kamil,
M.D., of WellPoint, Inc. subsidiary
Blue Cross of California, and Carrie
B. Frank, of Excellus Health Plan,
describe the structure of their P4P
programs and highlight their clinical,
utilization and financial results.
They share lessons learned during
their program development and refinement,
so you can apply their successes to
your P4P plans. ($292)
NEW FORMULARY
STRATEGIES FOR PART D: DECISIONS TO
MAKE BY THE APRIL 17 DEADLINE,
a 2-hour audioconference on March
2, 2006. Three experts from Gorman
Health Group — John Gorman,
president and CEO, Michael S. Flagstad,
director of the pharmacy benefits
practice, and Babette Edgar,
former director of formulary management
for CMS — will discuss emerging
trends and key issues in Part D formularies
for 2007, so that you can learn how
best to fulfill the new formulary
requirements. ($292)
PART D IMPLEMENTATION:
NEW PITFALLS TO AVOID FOR HEALTH PLANS,
PBMs AND PHARMA COMPANIES,
a CD of a two-hour audioconference
held on January 18, 2006. Two leading
Medicare experts — S. Lawrence
Kocot, senior advisor to the administrator
at CMS, and David Ralston, JD,
MPH, legal director for Schering-Plough
Corp. — dispense reliable intelligence
about how to deal with key implementation
issues of the Medicare Part D drug
benefit. ($267)
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