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AIS 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.
DRUG BENEFIT NEWS, unique information gathered in AIS's own surveys of HMOs and pharmacy benefit management companies. Timely news and data on the business of pharmaceuticals ... and practical cost management strategies from experts throughout the industry. Includes data on high-cost drug categories, inside info on what HMOs and PBMs are doing, and information that will help you benchmark results and experiences. 24 issues annually ($537 per year) or 2-month intro ($86 for 4 issues); both include print copy and e-mail delivery.
HEALTH PLAN WEEK, timely business, financial and regulatory news of the health insurance industry — with the inside news, targeted data and expert analysis that will help you monitor all of the changes ahead under health reform and improve your organization's bottom line. The health plan industry's most respected and widely read weekly news source since 1991. 45 issues annually ($677 per year) or 2-month intro ($91 for 8 issues); both include print copy and e-mail delivery.
The HCCA-AIS MEDICAID COMPLIANCE NEWS, monthly news and valuable how-to strategies for identifying and reducing the top Medicaid compliance risks. Co-published by the Health Care Compliance Association (HCCA) and AIS. 12 issues annually ($467 per year; HCCA member discount available); subscriptions include print copy and e-mail delivery of the newsletter.
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.
MEDICARE PART D COMPLIANCE NEWS, monthly news and strategies to help you monitor enforcement actions, assess your true compliance risks and design compliance programs and strategies that will save you time and reduce your risk of penalties and payments to CMS. You’ll get valuable updates on how Part D will be impacted by health reform. 12 issues annually ($467 per year); includes print copy and e-mail delivery.
REPORT ON MEDICARE COMPLIANCE, the industry's top source of news and analysis on Medicare compliance, fraud and abuse, billing errors, and a range of complex compliance issues. Includes unique strategic guidance not available anywhere else ... from the desk of veteran compliance reporter Nina Youngstrom, who has written this newsletter since 1992. 45 issues annually ($648 per year) or 2-month intro ($92 for 8 issues); both include print copy and e-mail delivery.
REPORT ON PATIENT PRIVACY (and AIS’s HIPAA Compliance Center), a highly practical print and Web service that will help your organization safeguard patient privacy and data security — and reduce your chances of fines and penalties, private lawsuits and public relations nightmares. Annual subscriptions include 12 issues of the industry-leading newsletter Report on Patient Privacy, and access to a regularly updated Web site — with 31 narrative sections written by experts (and packed with sample forms, policies, procedures and other practical tools you can adapt to your privacy and security compliance), a convenient listing of links to official documents pertaining to HIPAA privacy and security, and searchable archives of Report on Patient Privacy. ($429) REPORT ON RESEARCH COMPLIANCE, co-published by the National Council of University Research Administrators (NCURA) and AIS, provides the best information there is to help institutions avoid the negative publicity, financial setbacks, and management problems that compliance requirements can create. 12 issues annually, plus weekly e-mail newletters and unlimited access to a password-protected Web site. ($379 for NCURA members, $479 for non-members.)
SPECIALTY PHARMACY NEWS, a monthly newsletter with news and strategies for managing high-cost biotech and injectable products, designed to help health plans, PBMs, providers and employers manage costs more aggressively and deliver biotechs and injectables more effectively. Contains information on benefit design, provider contracting, reimbursement, network building, claims management, formulary decisions, and other pharmacy management issues. 12 issues annually ($495 per year) or 2-month intro ($84 for 2 issues); both include print copy and e-mail delivery.
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. A COMPREHENSIVE GUIDE TO MANAGING NEVER EVENTS AND HOSPITAL-ACQUIRED CONDITIONS provides guidance on patient safety and preventable adverse events to help you reduce risks, prevent lost reimbursement, increase quality of care and improve outcomes. Written by three top patient safety leaders — Robert F. Bunting, Jr., Jay Schukman, MD, and Wesley B. Wong, MD — this resource is the first of its kind to chronicle the efforts of the past decade to address the challenge of patient safety. Subscription includes a looseleaf guide, companion CD and one biannual update. ($287)
A GUIDE TO COMPLYING WITH STARK PHYSICIAN SELF-REFERRAL
RULES is a comprehensive looseleaf service written by a team
of experienced health care attorneys. It features easy-to-follow explanations
of the prohibitions and exceptions under the Stark rules, chapters devoted
to the special Stark interests of different stakeholders, summaries
of Stark Advisory Opinions issued by the OIG, and copies of regulations
and other formal documents. Subscription includes quarterly updates
and news summaries (in print and CD formats). ($524 annually).
HIGH-RISK AREAS IN MEDICARE BILLING is a comprehensive Web site with sophisticated compliance auditing tools for hospitals and health systems. Co-published by Strategic Management Systems, Inc. — one of the nation’s leading compliance consulting firms — and AIS, the site organizes (by high-risk area) hundreds of checklists, policies, best practices and other tools in downloadable formats that can be adapted by subscribers. Also includes a valuable monthly newsletter. ($787 per year)
49 STEPS TO IMPLEMENT SARBANES-OXLEY BEST PRACTICES IN PRIVATE AND NONPROFIT HEALTH CARE ENTITIES, a highly practical book — written by experienced compliance experts at Strategic Management Systems, Inc., led by former HHS Inspector General Richard P. Kusserow — that identifies and describes steps your organization can take to adopt what have become consensus best practice standards for adhering to this landmark corporate responsibility law. Includes a companion CD with templates that can be customized by your organization. ($385)
2000-2009 SURVEY RESULTS: PHARMACY BENEFIT TRENDS & DATA, a valuable book and CD resource that features the complete results — plus analyses — of AIS’s quarterly survey of pharmacy benefit management companies, from the second quarter of 2000 to the second quarter of 2009. It contains hundreds of charts, tables and graphs on costs, benefit design, utilization and PBM market share, plus a complete directory of PBMs, PBAs, SPPs and related companies. An accompanying CD contains all of the raw survey data in spreadsheet form. ($1,275)
THE AIS GUIDE TO BLUE CROSS AND BLUE SHIELD PLANS, a competitive intelligence resource from the editors of The AIS Report on Blue Cross and Blue Shield Plans. It contains reliable information on Blues plans’ products, market strategies, acquisitions and alliances — including financial projections and hard-to-find data on revenues, earnings, enrollment and medical loss ratios. (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.) ($427) CD version also available.
THE AIS GUIDE TO MEDICARE COMPLIANCE RISKS & STRATEGIES FOR HOSPITALS, PHYSICIAN GROUPS AND OTHER PROVIDERS, overview and analysis on the big-dollar topics of greatest concern to health care compliance professionals and anyone responsible for running a Medicare program. The book includes chapters on coding and billing, documentation, reimbursement, Recovery Audit Contractors, OIG audits, fraud and abuse, anti-kickback and Stark laws, privacy and data security, and more. CD version also available. ($378)
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)
AIS’s QUARTERLY PHARMACY BENEFIT SURVEY RESULTS, a unique resource containing the raw data from AIS’s quarterly survey of PBMs — that tracks growth and consolidation in the industry, and trends in costs, utilization and benefit design. Every four months, a new Excel spreadsheet is available to download, and includes data such as contact information, annual gross revenues, number of clients, number of prescriptions filled per year, and much more. ($150 per quarter)
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)
CONSUMER-DIRECTED HEALTH CARE: FACTS, TRENDS AND DATA is a comprehensive resource providing timely, reliable intelligence on rapidly changing market conditions — and what's working and what's not — in consumer-directed health (CDH) plans. It features case studies, results, plan designs, strategies, directories … and other practical information, including in-depth coverage of HSAs, and enrollment and trend information. It summarizes the liability and legal concerns raised by CDH care, strategies for incorporating the pharmacy benefit into CDH care, and much more. ($364)
GENETIC TESTING AND DIAGNOSTIC TOOLS IN THE PHARMACY BENEFIT examines the evolving presence and impact of genetic testing on health plans and the pharmacy benefit industry. It provides insight on coverage implications, pending legislation and government regulation, and some of the science behind the tests. ($84) PDF version available.
A GUIDE TO AUDITING AND MONITORING HIPAA PRIVACY COMPLIANCE, how-to-do-it guidance on installing effective HIPAA auditing and monitoring systems including practical templates, tools and documents on a companion CD. ($285)
HEALTH PLAN BUSINESS OUTLOOK 2010 addresses key issues health plans, the pharmaceutical industry and other related health care sectors will face in the coming year. AIS’s experienced health reporters interviewed dozens of leading experts across the health care industry to compile this report with valuable insights and forecasts for 2010. ($59) PDF version also available.
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.
HEALTH PLAN STRATEGIES FOR THE INDIVIDUAL MARKET contains valuable insight on the benefit design innovations, marketing tactics and legal challenges being faced by health plans in the individual (non-group) commercial health plan market. This report features enrollment data, exclusive insight from executives at Blue Cross and Blue Shield plans, Aetna, CIGNA and others on balancing premiums against rising medical costs, and detailed analysis of coverage rescission issues. ($84) PDF version also available.
HEALTH PLAN STRATEGIES FOR VALUE-BASED BENEFIT DESIGN examines the experiences of health plans and employers that have implemented value-based benefit design programs, and provides details of how companies adjusted copays and other benefits, provided incentives to join disease management programs, educated enrollees and measured results. It includes case studies and presentations from pioneers in the value-based insurance design movement, with best practices — and key pitfalls to avoid — when launching a new program. ($84) PDF version also available.
HSA SNAPSHOT: DATA, TRENDS AND PROJECTIONS provides a look at the growth of health savings accounts, and what major consumer-directed health industry players expect to happen next. This compilation includes survey results and data on enrollment, accounts and account balances, plus expert predictions on the growth — and the obstacles — the industry will face in coming years. ($47) PDF version also available.
KEY FINANCIAL INDICATORS FOR LEADING HEALTH PLANS, a quarterly spreadsheet with up-to-date financial data points for 50 leading health plans. The Excel file compares nine indicators — premium revenue, hospital/medical costs, pharmacy costs, total medical costs, medical cost ratio, administrative costs, administrative expense ratio, net income (loss) and net margin. ($141 per quarter)
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.
MANAGING CANCER CARE: STRATEGIES TO IMPROVE OUTCOMES AND LOWER COSTS examines recent developments from companies leading the way in the complex oncology management field. This valuable report takes a look at some of the management strategies and pricing methodologies that health plans have been instituting in hopes of reining in costs, as well as the federal government’s role in reimbursement. ($69) PDF version also available.
MEDICARE PART D: A COMPREHENSIVE ANALYSIS OF CMS RULES distills from thousands of pages of CMS regulations and guidance the major rules, guidelines and deadlines you need to comprehend the complex Medicare drug benefit program. It includes nine detailed chapters on sponsors, eligibility and enrollment, formularies, CMS enforcement and much more. ($124)
NEW MARKETING RULES AND ENFORCEMENT AFFECTING MEDICARE ADVANTAGE AND PART D PLANS is filled with ideas for how health plans can boost their focus on complying with CMS marketing rules and the provisions of the Medicare Improvements for Patients and Providers Act (MIPPA). It includes case studies and analysis of CMS actions, including the suspension of marketing and enrollment against several major MA and Part D plans, and new corrective action plans reached with many other plans. ($69) PDF version also available.
THE NEXT GENERATION OF DISEASE MANAGEMENT: 2009 AND BEYOND, a thought-provoking book that provides expert insight into where the DM industry is headed. Ten leaders in the DM industry weigh in on pressing issues such as: the build-versus-buy debate; using predictive modeling; measuring results; integrating care coordination; leveraging technology; and much more. ($223)
PBM CONTRACTING AND TRANSPARENCY ISSUES AND MODELS examines which contracting strategies have been successful, and which have failed or have contributed to confusion among pharmacy benefit clients. It details the decisions that factored into many contract negotiations, both in the public and private sectors, and pays particular attention to the role of transparency in these negotiations. ($84) PDF version also available.
RACs: STRATEGIES TO REDUCE YOUR RISK AND SUCCESSFULLY APPEAL PAYMENT DENIALS is a comprehensive report that offers guidelines on areas ripe for review and strategies on how to effectively appeal recovery audit contractor (RAC) payment denials. Learn about keys to success, including auditing and evaluating particular areas before the RACs do, establishing processes for records requests and appeals, and reducing your risk exposure. ($84) PDF version also available.
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.
VENDOR GIFTS AND RELATIONS: EFFECTIVE STRATEGIES FOR HEALTH SYSTEMS AND HOSPITALS, a report that shows you how to identify and manage potential gift conflicts, avoid possible compliance minefields and make sure patient care decisions are not influenced by vendor gift-giving. It provides guidance in the applicable laws and regulations, and offers samples of policies and real-world experiences of compliance officers who have successfully implemented these programs. ($84) PDF version also available.
Meetings
are listed below in reverse chronological order, 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.
HIPAA SECURITY BREACHES: 10 STEPS TO TAKE WHEN A BREACH OCCURS, a 90-minute Webinar on February 24, 2010. Find out the exact steps you should take to minimize the damage caused by a security breach and prevent impermissible disclosures down the road from two privacy experts, Rebecca Fayed, an attorney with Sonnenschein Nath and Rosenthal LLP in Washington, D.C., and Greg Young, the privacy and information security officer at Mammoth Hospital in Mammoth Lakes, Calif. ($329)
Recordings of Past Meetings NEXT-GENERATION ONCOLOGY MANAGEMENT STRATEGIES FOR HEALTH PLANS, a recording of a 90-minute audioconference held on January 28, 2010. Learn about innovative oncology management strategies that can lower costs without sacrificing patient outcomes — from Winston Wong, Pharm.D., associate vice president of pharmacy management at CareFirst BlueCross BlueShield, and Beckie Fenrick, Pharm.D., director of clinical pharmacy programs at Blue Cross Blue Shield of Florida, Inc. (BCBSF). ($329)
INDIVIDUAL AND SMALL-GROUP INSURANCE: HOW TO GRAB MARKET SHARE BEFORE REFORM, a recording of a 90-minute audioconference held on December 16, 2009. Get an overview of the rapidly changing sales and marketing landscape for small-group and individual products, and learn practical steps for reaching these key customer groups in 2010 — from Mark Carroll, a founding partner of Small Business Insurance Solutions (SBIS), C. Steven Tucker, founder and principal broker of Small Business Insurance Services, and Scott Leavitt, owner of Scott Leavitt Insurance & Financial Services. ($329)
HOW TO AMEND HIPAA BUSINESS ASSOCIATE AGREEMENTS TO COMPLY WITH THE HITECH ACT: STRATEGIES FOR MEETING THE FEBRUARY DEADLINE, a recording of a 90-minute audioconference held on December 8, 2009. Veteran HIPAA attorney Reece Hirsch, a partner with Morgan, Lewis & Bockius LLP in San Francisco, outlines specific steps your organization should consider for revising your business associate agreements to comply with new HITECH Act rules, before the February 2010 deadline. ($329)
HOW TO COMPLY WITH NEW GENETIC-TESTING REGS WITHOUT GUTTING DM AND WELLNESS PROGRAMS, a recording of a 90-minute audioconference held on November 19, 2009. Get reliable information on strategies health plans can adopt now to comply with and prevent damage from the new GINA rules, while preserving the value of your disease management and health risk initiatives — from John Hickman, Esq., head of Health & Welfare Benefits in the Employee Benefits and Executive Compensation Group at Alston & Bird, LLP, Joanne Hustead, Esq., senior health compliance specialist in the National Compliance Practice at The Segal Co., and Cheryl Risley Hughes, Esq., of counsel to the Groom Law Group. ($329)
HEALTH PLANS VS. DRUGMAKERS: THE BATTLE OVER COPAY SUBSIDIES, a recording of a 90-minute audioconference held on November 5, 2009. Get valuable insights and practical advice on how health plans can track and counteract pharmaceutical manufacturers’ copayment subsidy programs — from Michael Cartier, executive vice president of Envision Pharmaceutical Services, Inc., and George Van Antwerp, general manager of pharmacy solutions at Silverlink Communications, Inc. ($329)
HEALTH REFORM’S NEW REQUIRED BENEFIT DESIGN FOR INDIVIDUAL PLANS: IMPLICATIONS FOR INSURERS, a recording of a 90-minute audioconference held on September 24, 2009. Find out what requirements Congress likely will mandate for individual products. How will health insurers need to overhaul benefit designs, underwriting and premiums in order to meet the standards? What should they do now to prepare for this? Speakers are: Dave Tuomala, a director of actuarial consulting at Ingenix Consulting, and Scott Leavitt, owner of Scott Leavitt Insurance & Financial Services and the former president of the National Association of Health Underwriters. ($329)
USING COMPARATIVE EFFECTIVENESS AND COST DATA IN DRUG-ACCESS DECISIONS: NEW HEALTH PLAN STRATEGIES, a recording of a 90-minute audioconference held on September 9, 2009. Learn what strategies health plans, PBMs and specialty pharmacy providers are pursuing to generate and utilize their own CER and cost data and/or obtain them from external sources ... and how payers are using this information to evaluate various treatment options. Speakers are: Gary Owens, M.D., president of Gary Owens Associates, Sarah Collins, president of PharManage, LLC, and Steve Miller, M.D., of Express Scripts, Inc. ($329)
MEDICARE PART D REFORM: STRATEGIES TO PREPARE FOR POTENTIALLY ENORMOUS CHANGES IN 2010, a recording of a 90-minute audioconference held on August 6, 2009. With Medicare Part D a major focus of pending health care reform legislation, there is an urgent need for Part D plan sponsors to work with their PBMs and other first-tier entities to prepare for possible changes. Susan Hayes of Pharmacy Outcome Specialists and Steve Arbaugh of ATTAC Consulting Group provide details of what to do now to prepare for the potential impact of various health care reform proposals on Part D. ($329)
UCR RATE LITIGATION: HEALTH PLAN STRATEGIES FOR MINIMIZING FINANCIAL AND LEGAL RISKS, a recording of a 90-minute audioconference held on July 29, 2009. Find out what to do to minimize your risk of facing Ingenix-based UCR and prompt-pay lawsuits — from Edward Kaplan, senior vice president, national health practice leader in The Segal Company’s New York office, and Matthew Katz, executive vice president of the Connecticut State Medical Society. ($329)
RECONCILING PART D ENROLLMENT DATA: STRATEGIES TO AVOID BECOMING AN ENFORCEMENT TARGET, a recording of a 90-minute audioconference held on January 13, 2009. Learn the details of effective strategies to improve your enrollment and membership reconciliation processes and ensure that they are in compliance with CMS requirements, from three experts with Global Pharmaceutical Solutions (GPS) — Managing Partner Erin Costell, and Senior Consultants Marye Issacs and Julian Nadolny. ($329)
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)
STRATEGIES TO PREVENT AND SUCCESSFULLY APPEAL RAC PAYMENT DENIALS, a recording of a 90-minute audioconference held on November 18, 2008. Learn what your organization should do to prepare for RAC audits and which strategies have been used with terrific success to reverse unfavorable outcomes and to prevent future risk exposure — from two industry leaders with vast experience in representing hospitals and health systems during RAC audits: Diane Cahalan, a director in PricewaterhouseCoopers LLP’s (PwC) Health Industries Advisory Practice, and Lawrence Vernaglia, a partner with Foley & Lardner LLP. ($329)
INNOVATIVE ONCOLOGY PARTNERSHIPS: HOW TO IMPROVE OUTCOMES AND EFFICIENCIES, a recording of a 90-minute audioconference held on October 29, 2008. A team of experts — Lynn Nishida, director of clinical pharmacy services for RegenceRx, Richard McGee, M.D., a medical oncologist and co-founder and president of Puget Sound Cancer Centers, Nicholas Opalich, the managing principal of Strategica Health Partners, L.L.C., and David Chess, M.D., founder and CEO of Enhanced Care Initiatives Inc.— outline effective strategies that payers and providers can use collaboratively to improve clinical outcomes and increase efficiencies. ($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)
VACCINE COVERAGE AND BILLING STRATEGIES UNDER PART D, a recording of a 90-minute audioconference held on September 25, 2008. Andrea Serrate, CPA, vice president of specialty and payer services for Poc Network Technologies, Inc., provides valuable intelligence about CMS’s new vaccine coverage and administration billing requirements and options. Learn how to cover and bill for vaccines correctly to avoid CMS sanctions and enforcement action. ($329)
BENEFIT DESIGN AND MARKETING FOR INDIVIDUAL HEALTH INSURANCE PRODUCTS: “LIFE STAGE” STRATEGIES FOR HEALTH PLANS, a recording of a 90-minute audioconference held on July 30, 2008. Learn practical steps toward developing products with the right price points and product designs, and marketing them with messages that are reaching their intended market — from Laurie Brubaker, COO for Aetna, Inc.’s Consumer Segment. ($329)
NEXT-GENERATION SPECIALTY PHARMACY MANAGEMENT STRATEGIES FOR HEALTH PLANS, a recording of a 90-minute audioconference held on July 9, 2008. Find out what new strategies insurers are using — and should use — to manage high-cost specialty drugs, from Debbie Stern, R.Ph., vice president of Rxperts, and Edmund Pezalla, M.D., national medical director at Aetna Pharmacy Management. ($329)
HOW TO LOWER RX COSTS IN PBM CONTRACTS: STRATEGIES FOR HEALTH PLANS AND EMPLOYERS, a CD of a 90-minute audioconference held on June 12, 2008. Get expert guidance about the RFP process, PBM contracts, and the crucial strategies Rx payers should employ to achieve the lowest feasible drug spend — and not waste millions of dollars. Speakers are: Linda Cahn, president of Pharmacy Benefit Consultants, and Dan Coady, director of pharmacy benefit administration (PBA) strategies at HealthTrans LLC. ($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.
VENDOR GIFTS AND RELATIONS: HOW TO REVISE YOUR HOSPITAL’S STRATEGIES AS THE FEDS CRACK DOWN, a recording of a 90-minute audioconference held on March 25, 2008. Learn how to identify and manage potential vendor gift conflicts, to avoid possible compliance minefields and ensure patient care decisions are not influenced by vendor gift-giving. Speakers are: Donald E. Koenig, Jr., vice president and assistant general counsel of corporate responsibility and enterprise risk management for Catholic Healthcare Partners (CHP) in Cincinnati, and Nickie Braxton, corporate compliance officer for Hartford (Conn.) Hospital/Hartford Health Care Corp. ($329)
ORAL ONCOLOGY DRUGS: HEALTH PLAN STRATEGIES FOR AN EVOLVING MARKET, a recording of a 90-minute audioconference held on February 28, 2008. Find out what strategies plans are (or should be) using to manage oral oncology drugs, and what trends insurers should prepare for — from Lee N. Newcomer, M.D., senior vice president of oncology for UnitedHealthcare, Randy Falkenrath, senior vice president of specialty pharmacy and business development for UnitedHealth Pharmaceutical Solutions (UHPS), and Thomas McNulty, Pharm.D., chief clinical officer for Ancillary Care Management, Inc. (ACM). ($329)
“DRUG MIX” STRATEGIES FOR HEALTH PLANS AND PBMs: WAYS TO LOWER Rx COSTS AND WIN BUSINESS, a CD of a 90-minute audioconference held on February 13, 2008. Three leading pharmacy experts — Jake Cedergreen of Express Scripts, Helen Sherman of The Regence Group's RegenceRx and Tim Watson of Pharmaceutical Strategies Group — provide strategic insights on how health plans and PBMs can develop an effective drug mix, and thereby differentiate themselves in the marketplace. ($329)
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1100 17th Street, NW, Suite 300, Washington, DC 20036
Phone 202-775-9008 or 800-521-4323; E-mail customerserv@aispub.com