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Publication Details
- Pub Code: GBLU3-11WEB
- Pages: 282
- ISBN: 978-1-936230-23-5
- Copyright 2012
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The AIS Guide to Blue Cross and Blue Shield Plans: 2012
Published independently by Atlantic Information Services. Not affiliated with or sponsored, endorsed or approved by the Blue Cross and Blue Shield Association or any of the independent Blue Cross and Blue Shield companies.
Provides competitive intelligence on the major players in U.S. health insurance. The book contains reliable information on Blues plan products, market strategies, acquisitions and alliances, and features financial projections and hard-to-find data on revenues, earnings, enrollment and medical loss ratios.
Reliable information on Blues’ products, market strategies, acquisitions and alliances
From the publishers of the successful monthly newsletter The AIS Report on Blue Cross and Blue Shield Plans,* comes the completely updated competitive intelligence resource, The AIS Guide to Blue Cross and Blue Shield Plans: 2012.* It contains 12 information-packed chapters, with facts, trends and data about:
- Blues’ solutions to regulatory challenges under health care reform, including exchanges, Medicaid expansion programs, medical loss ratios and refunds.
- Blues’ innovative approaches to provider relations, such as “Most Favored Nation” clauses, provider incentives, accountable care organizations, quality contracts and patient-centered medical homes.
- Blues’ continuing development of cost-saving operational tactics, such as health improvement initiatives and collaborations, oncology management tactics, utilization of electronic health records and e-prescribing initiatives.
Whether you count Blue Cross and Blue Shield plans as partners or competitors, The AIS Guide to Blue Cross and Blue Shield Plans contains reliable information on Blues’ products, market strategies, acquisitions and alliances. It includes financial projections and hard-to-find data on executive compensation, revenues, earnings and enrollment, plus insight into premium trends, rate hike proposals, and more. You can use this information to gain an understanding of Blues plans’ market strategies, operational tactics and cost-containment techniques.
This unique resource is the only place you can find reliable data on Blues’ history, function and structure, along with:
- BCBS trade names and marketing advantages,
- BCBS licensee requirements and association guidelines,
- BCBS plan executive compensation stats,
- Mergers, acquisitions and leadership changes, and
- A directory of Blue Cross and Blue Shield plans.
*The AIS Guide to Blue Cross and Blue Shield Plans: 2012 and The AIS Report on Blue Cross and Blue Shield Plans are published independently by AIS. They are not affiliated with or sponsored, endorsed or approved by the Blue Cross Blue Shield Association or any of the independent Blue Cross and Blue Shield companies.
CD Version Available for Easy Data Manipulation and Fast Searching! The CD version of The AIS Guide to Blue Cross and Blue Shield Plans: 2012 is packed with data and analysis not contained in the print version such as previous year data, to allow for year-over-year comparison for many enrollment and financial data points. It includes all the data in Excel spreadsheets, so you can easily create your own analyses, as well as directory contact information, and a complete user-friendly PDF version of the book for fast searching. Plus, all CD purchasers receive a free copy of the print version!
Table of Contents
Chapter 1. What Is a Blue Cross and Blue Shield Plan?
- History, Function and Structure of the Blue Cross and Blue Shield Association
- BCBSA Licensee Requirements and Association Guidelines
- BCBS Trade Names and Marketing Advantages
- Political Donations, Lobbying Efforts and Expenses
Chapter 2. Corporate Leadership, Structure and Events
- Mergers, Acquisitions and Major Moves
- Highmark M&A Activity
- BCBS Plan Executive Compensation
- BCBS Plan Leadership and Staff Changes
Chapter 3. Enrollment Statistics and Market Share
- Membership Gains and Losses
- National Enrollment and Market Share for BCBS Plans
- Enrollment Breakdown by Sector and Risk for BCBS Plans
- Blues Enrollment and Market Share by State
- Competitive Landscape in 15 Important BCBS Markets
Chapter 4. Financial Performance of BCBS Companies
- Publicly Traded BCBS Organizations’ Financial Results
- Not-for-Profit BCBS Organizations’ Financial Results
- Administrative Spending
- Reserve Levels
- Financial Ratings
- Key Financial Indicators
Chapter 5. Health Care Reform and Regulatory Survival Strategies
- Health Reform Impact and Outlook
- Marketing Strategies and Retail Presence
- Health Insurance Exchanges and High-Risk Pools
- Medicaid Markets and Expansion Programs
- Medical Loss Ratios
Chapter 6. Premiums and Rate-Setting Issues
- Premium Strategies and Trends
- Refunds and Give-Backs
- Rate Hike Proposals, Awards and Denials
- California
- Connecticut
- Maine
- Michigan
- New Mexico
- North Carolina
- Pennsylvania
- Rhode Island
Chapter 7. Product Offerings and Contracts in Specific Markets
- Federal Employee Health Benefits Plan
- Individual (Non-Group) and Small Group Products
- Group Health Marketing and Brokers
- Local Market Issues and Strategies
- Medicare Advantage, Part D and Medigap Markets
- Medicaid, SCHIP and Local Public Programs
Chapter 8. Provider Relations, Fees and Conflicts
- Accountable Care Organizations
- Patient-Centered Medical Homes
- Alternative Quality Contracts and Global Payment Systems
- Most-Favored-Nation Clauses
- Provider Incentives and Quality Data
- Contract Disputes and Controversies
- Networks and Nurses
Chapter 9. Coverage Issues and Specialty Benefits
- Pharmacy Benefit Strategies and Results
- Home Care Coverage and Initiatives
- Autism and Mental Health
- Coverage Conflicts and Decisions
Chapter 10. Wellness, Prevention and Disease Management Programs
- Health Improvement Initiatives and Collaborations
- Oncology Management
- Obesity and Smoking Cessation
Chapter 11. Information Technology and Claims-Processing Issues
- Electronic Health Records
- Social Media and Web Marketing
- Operational Software and Systems
- ICD-10 Implementation Strategies
- Security Breaches and Issues
- e-Prescribing Initiatives
- Fraudulent Claims
Chapter 12. Directory of Blue Cross and Blue Shield Plans
Written By
The AIS Guide to Blue Cross and Blue Shield Plans is written and edited by the editorial staff of Atlantic Information Services.
Written For
- HMOs, PPO and POS plans
- Insurers
- Hospitals and health systems
- Group practices
- Pharmaceutical companies
- Other health care organizations
AIS Guarantee
Order The AIS Guide to Blue Cross and Blue Shield Plans for a 30-day risk-free inspection and test for yourself the value of this highly practical resource. If within 30 days you're not interested in keeping it, just return it to AIS and we will send you a prompt, full refund or credit. For CD purchasers, refunds will not be made once the seal on the CD package has been broken. Please review your copy of the print version prior to breaking the seal.
Shipping Information
This item is shipped via UPS. Please give us your street address when you order (UPS does not deliver to PO boxes.) You should receive your order within 5-7 business days. Shipping and handling cost is $12 per item.
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The AIS Guide to Blue Cross and Blue Shield Plans: 2012
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