|
| Sample Newsletters | MarketPlace AIS Products & Services |
|
|
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 (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.
INSIDE CONSUMER-DIRECTED CARE brings you timely news and insightful analysis on how the trend toward consumer-directed health plans will affect utilization of medical services, insurance premiums, and your bottom line. You'll get concise details on topics like who's getting what contracts, how plans are being structured, how to get employees to buy in, critical factors for plan success, whether incentives will foster use of cost-effective care, and how plans and employers will educate and communicate with beneficiaries. Get reliable intelligence on what's working and what's not and why. 24 issues annually ($446 per year) or 2-month intro ($82 for 4 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 ($417 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, news and strategies on implementation and compliance with the Medicare drug benefit — marketing, enrollment, formularies, rebates, claims pricing, and fraud, waste and abuse. 12 issues annually ($467 per year) or 2-month intro ($71 for 2 issues); subscriptions include print copy and e-mail delivery of the newsletter, biweekly "Part D E-Letters" and access to a special Part D Web site for easy access to all original documents.
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 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. AIS’s HIPAA COMPLIANCE CENTER, a highly practical Web and print 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 30 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)
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. ($687 per year)
63 BILLING AND CODING STRATEGIES FOR AVOIDING MEDICARE FALSE CLAIMS is a comprehensive collection of highly practical articles on false claims cases, government billing and coding investigations, and a wide range of Medicare billing and coding problems to avoid. This report will guide you around many of the most common pitfalls in Medicare billing and coding, cost report errors, bad documentation, DRG upcoding, and other problems that can result in enormous fines and penalties against your organization. ($69)PDF version also available.
2000-2007 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 first quarter of 2000 to the second quarter of 2007. 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. ($1,175)
2007 HSA COMPLIANCE GUIDE: A PRIMER ON THE MOST CRITICAL TREASURY, IRS AND DOL GUIDANCE covers seven rounds of guidance issued by the Treasury Dept., Labor Dept. and the IRS between early 2005 and early 2007. Includes in-depth analysis — plus the actual government guidance(s) — on the rules that clarify how HSAs are to be treated, and offers a sneak peek at some of the questions and answers that will likely be included in the soon-to-be-released “HSA Grab-Bag” guidance. ($69) PDF version also available.
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 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)
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.
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 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 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.
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.
HSA DIRECTORY AND RESOURCE GUIDE, a comprehensive directory of HSA firms containing up-to-date information on more than 400 HSA administrators and custodians — with names, titles and mailing addresses for more than 1,200 HSA executives. Also features information on fees, geographic area, number of accounts, deposits, product descriptions and more. ($447, includes companion CD-ROM)
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.
MEDICAID FRAUD CRACKDOWNS AND COMPLIANCE is packed with case studies that will show you what health organizations should expect under the federal Deficit Reduction Act (DRA).This report explains what sparked the Medicaid enforcement push, how it affects providers and what actions your organization should take now. ($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)
MEDICARE PRIVATE-FEE-FOR-SERVICE: HEALTH PLAN STRATEGIES FOR A BOOMING BUT CONTROVERSIAL PRODUCT is designed to help health plans and their partners design PFFS products that meet the goals of beneficiaries and providers, while avoiding investigations and enforcement actions by regulatory authorities. Based on an AIS audioconference, this report shares strategies from two of the nation's top Medicare managed care experts that will help you seize the current and future opportunities in PFFS. ($137) PDF version also available.
NEW DEVELOPMENTS IN HSA AND OTHER CONSUMER-DIRECTED HEALTH PRODUCT PLAN DESIGN: Trends, Recent Developments, Case Studies, and Tools and Resources provides an overview of the major trends influencing the CDH market, case studies of how plans of various designs were implemented and introduced by the major players and experts in the field, and insights about the direction of CDH plan design today and in the future. ($69) PDF version 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.
ONCOLOGY DRUG MANAGEMENT: A WHITE PAPER ON MARKETPLACE CHALLENGES, OPPORTUNITIES AND STRATEGIES, a white paper by pharmacy benefit expert Chris Nee. Filled with data and illustrations that clearly explain the oncology drug management industry’s history and current climate, this white paper includes case studies of various reimbursement scenarios and practical advice on how to design a cost-effective oncology drug program. ($156) PDF version also available.
PART D APPEALS & GRIEVANCES: STRATEGIES FOR MINIMIZING COMPLIANCE RISKS examines key issues surrounding Part D appeals and grievances. This report, based on a January 25, 2007, audioconference, shares expert advice on how to structure an effective appeals and grievances procedure — one that will help you avoid becoming a target of CMS enforcement. ($137) PDF version also available.
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.
PBM FORMULARY STRATEGIES AND THEIR IMPACT ON PAYERS provides payers and interested parties with insight into the formulary management tools and practices offered by some of the nation's leading PBMs. PBM practices surrounding formulary management have come under intense scrutiny in recent months. How PBMs collect rebates on formulary products is a topic of much discussion and speculation, even as PBMs continue to hold confidential many details on rebate collection from pharmaceutical manufacturers. This book gives you the basic ingredients you need to conduct detailed formulary comparisons between PBM vendors. Written by Tim Watson, Pharm.D., M.B.A. ($84) PDF version also available.
PBM TRANSPARENCY: WHAT RECENT NEWS EVENTS MEAN FOR PAYERS, PBMs AND OTHER STAKEHOLDERS examines key developments and issues surrounding the PBM industry’s march toward greater transparency. Based on an AIS audioconference, this report shares advice from three experts with different perspectives on the industry, on how you can make sense of, prepare for and take advantage of recent trends in PBM transparency. ($137) PDF version also available.
PRESCRIPTION DRUG REBATES AND EVOLVING REIMBURSEMENT METHODOLOGIES is a primer on the basics of drug rebates — how they have evolved over the years and continue to change. It examines how the health care industry has reacted to new reimbursement methodologies, and details strategies that have been successful, as well as ones that have increased confusion or conflict. ($84) PDF version 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.
STATUS OF 104 DRUGS ON 30 HMO FORMULARIES provides information on some of the most widely prescribed pharmaceutical products (including some of the most popular injectables that are beginning to be covered under the pharmacy benefit) on 30 different HMO formularies as of February/March 2005. It will give you valuable insights you can put to use in establishing or modifying your own formulary. ($69) PDF version also 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.
RECONCILING PART D ENROLLMENT DATA: STRATEGIES TO AVOID BECOMING AN ENFORCEMENT TARGET, a 90-minute audioconference 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)
Recordings of Past Audioconferences
HEALTH REFORM UNDER PRESIDENT OBAMA: LIKELY PRIORITIES AND TIME FRAMES FOR 8 POSSIBLE INITIATIVES, a recording of a 90-minute audioconference held on December 9, 2008. Get insider intelligence on the likely timing and priority of sweeping health system reform and seven other important federal initiatives, from two veteran observers of Washington health policy — Bruce Merlin Fried, a partner at Sonnenschein Nath & Rosenthal LLP and former HCFA managed care director, and Henry J. Aaron, a senior fellow in the economic studies program at the Brookings Institution. ($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)
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)
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)
DEBIT CARDS AND HEALTH PLANS: HOW NEW IRS RULES WILL SAVE MONEY AND IMPROVE MEMBER SATISFACTION, a recording of a 90-minute audioconference held on September 23, 2008. Chris Byrd, executive vice president of operations and development at Evolution Benefits, Inc., John Duisberg, manager of business development at Availity L.L.C., and Michael Plumb, a business development consultant for Blue Cross and Blue Shield of Florida, will discuss the effect IRS rules regarding the Inventory Information Approval System (IIAS) will have on health care transactions, the cost savings involved when debit cards eliminate virtually all health plan paperwork, and the impact this revolution could have on member satisfaction. ($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)
UPCOMING CMS MEDICAID AUDITS: STRATEGIES FOR MINIMIZING YOUR CHANCES OF ADVERSE FINDINGS, a recording of a 90-minute audioconference held on June 19, 2008. Attorneys Judith Waltz and Daniel Reinberg of Foley & Lardner LLP provide practical strategies for identifying specific Medicaid risks, and preparing for the inevitable CMS Medicaid Integrity Program audits and aggressive Medicaid enforcement that is on the way. ($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)
NEW MEDICARE ADVANTAGE AND PART D MARKETING RULES: KEY STRATEGIES FOR HEALTH PLANS, a recording 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.
2009 MEDICARE ADVANTAGE RATES: IMMEDIATE STRATEGIES FOR HEALTH PLANS, a CD of a 90-minute audioconference held on April 29, 2008. Find out how to revise your product and pricing strategies to prepare the best possible bids before the submission deadline — in light of the 2009 MA payment rates. Speakers are: Pat Dunks, principal and consulting actuary with the Milwaukee office of Milliman, and Brian Weible, president of Wakely Consulting Group. ($329)
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)
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)
THE DEC. 29, 2007 MEDICARE LAW: IMMEDIATE STRATEGIES FOR HEALTH PLANS, a recording 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)
HSAs AND PREVENTIVE DRUGS: HOW TO REDUCE YOUR RISKS WITH THE IRS, a CD of a 90-minute audioconference
held on December 18, 2007. Get advice on how to determine whether a preventive drug can be covered outside of the deductible and ensure that the health plan remains HSA-compliant. Speakers are: John Hickman, Esq., head of Health & Welfare Benefits in the Employee Benefits and Executive Compensation Group at Alston & Bird, LLP in Atlanta, Nancy Summa, a product manager for consumer-directed products at Aetna, and Tracy Grunsfeld, Medco’s vice president of insured and emerging markets. ($329)
EFFECTIVE HEALTH PLAN STRATEGIES FOR MANAGING EPOETIN PRODUCTS, a CD of a 90-minute audioconference held on September 27, 2007. Find out how health plans are managing drugs like Epogen and Procrit to assure best health outcomes for patients, and best financial outcomes for their own bottom lines. Speakers are: Helen Sherman, R.Ph., Pharm.D., senior director of pharmacy services and chief pharmacy officer at The Regence Group's RegenceRx, and Michael Joslin, chief operating officer of CareCore Oncology and executive vice president of CareCore National, LLC. ($322)
MEDICATION THERAPY MANAGEMENT: DESIGNING PROGRAMS TO ACHIEVE BETTER OUTCOMES AND ROI, a CD of a 90-minute audioconference held on November 14, 2007. Learn specific steps you should take to implement emerging best practices for MTM programs, and produce the best results for your bottom line — from two experts on health plan and PBM strategies for MTM: Jim Langman, vice president of clinical services at Walgreens Health Services, and Edmund Pezalla, M.D., national medical director at Aetna Pharmacy Management. ($322)
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)
OPTIMIZING SPECIALTY PHARMACY BENEFITS: STRATEGIES FOR HEALTH PLANS, a CD of a 90-minute audioconference held on October 17, 2007. Learn strategies health plans are using to give members the best benefits possible — and to rein in specialty drug spending. Speakers are: Robert Giles, Jr., Pharm.D., senior manager of formularies and specialty pharmacy at BlueCross BlueShield of Tennessee (BCBST); F. Michael White, Pharm.D., manager of pharmacy care management at BCBST; Al Heaton, Pharm.D., director of pharmacy at Blue Cross Blue Shield of Minnesota; and Debbie Stern, R.Ph., vice president of Rxperts. ($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) |
