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| Special Needs Plans: Regulatory Challenges and Market Strategies |
Special Needs Plans: Regulatory Challenges and Market Strategies is your guide to Medicare Advantage Special Needs Plans (SNPs), one of the most complex — and important — areas of health care, and one that’s getting changed dramatically as a result of the new health care reform law.
- How are the SNPs that are successful doing it?
- What financial and regulatory problems are other SNPs running into?
- What impact did new rules affecting chronic care SNPs have so far, and what are they likely to have in the future?
- Why are some operators expanding in dual-eligible SNPs while others are getting out?
- What impact will the reform law have on SNPs?
These are the kinds of questions that Special Needs Plans: Regulatory Challenges and Market Strategies will help you answer. It looks at major developments during the past few years from both a business and regulatory standpoint, including business case studies and government actions at both the federal and state levels. Plus – the report features a comprehensive directory of SNPs and their enrollment, highlighting the emerging and dominant players.
The special rules that apply to these plans can bring both problems to weaker players and expansion opportunities for stronger ones. Learn how to be one of the strong ones – order Special Needs Plans: Regulatory Challenges and Market Strategies today!
Table
of Contents
Federal Regulation of Special Needs Plans
- CMS Guidance Clarifies Minimum MA Plan Enrollment; SNPs Fear Cost-Sharing Rules
- Reform Law’s Provisions on OEP and MLRs May Hurt MA Plans; SNPs Get Gains, Losses
- CMS C-SNP Rules for ’10 Could Add Costs, Cause Confusion, Lead to Viability Fears
- SNP Provisions of New Medicare Law Draw Praise, Concern About Short-Term Authority
- Senate Medicare Bills Would Extend SNP Authority, Stretch Moratorium for Disproportionate SNPs
Marketing for Special Needs Plans
- Medicaid Plans Report Challenges, Savings Potential in Care for Duals
- CMS Puts United’s Evercare ‘Under Microscope’ After Questionable Sales Tactics
- CMS Issues Final Call Letter, Clarifying SNP, Marketing Issues
SNP Strategies
- SCAN I-SNP Saved Medicare $250M Over Two Years, Avalere Study Finds
- Observers See SNPs Faring Well Despite Payment Cuts, New Rules
- XLHealth Expands Into SNPs For Dual Eligibles as of Jan. 1, 2010
- JMH Health Prepares to Enter MA Program, Puts Finishing Touches on Dual SNPs for ’10
- N.J. Plans to Cancel Dual SNP Contracts; Texas Moves Ahead on Integration Effort
- Number of PFFS Plans, SNPs Falls for ’09, While Local PPOs Continue to Increase
- SunHealth, Others Assert Payment for C-SNPs Remains Challenging
- More MA Plans Hope to Launch PPOs Soon, But Some May Hold Back on SNPs for 2010
- Centene Expands Into SNP Markets
- Industry Explores PPOs, Benefit Designs to Manage Limits Placed By SNP Moratorium
- AmeriChoice Signs Agreement to Acquire SNP Operator Unison
- Profile Shows High Risk Score, Better Hospital Usage for SNPs
- Calif. SNP for Mentally Ill Cites Reductions in Inpatient, ER Use
Special Needs Plan Enrollment Data
Written
By
This
book was written by the editorial staff of AIS.
Written
For
- Health plan business and financial managers (CEOs, CFOs, product and sales managers, government affairs managers)
- Executives of pharmaceutical manufacturers and PBMs
- Hospital and health system business and financial executives
- Consultants, actuaries, financial analysts and attorneys
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Related
Publications
Medicare Advantage News
Managed Medicare and Medicaid Factbook
Health Plan Week
Health Plan Facts, Trends and Data
AIS’s Directory of Health Plans
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