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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.
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. Subscriptions include monthly print newsletters (delivered by mail and also e-mailed as a PDF), and twice-monthly E-News Alerts ($446 per year, or $82 for a 2-month intro).
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.
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. ($687 per year)
35 EMPLOYER CASE STUDIES IN CONSUMER-DIRECTED CARE: Tips and Strategies From Employers that Are Pioneering HSA- and HRA-Based Health Plans profiles dozens of large and small employers that have introduced an account-based consumer-directed health plan. These profiles include enrollment results and detailed plan design information (e.g., annual deductibles, HSA and HRA contributions, coinsurance, preventive care coverage, out-of-pocket maximums), and are based on interviews with the benefits consultants and human resources executives who developed the plans and educated employees about how they work. ($69) PDF version also available.
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.
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. ($427) CD 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 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)
BLUE CROSS AND BLUE SHIELD STRATEGIES FOR THE INDIVIDUAL MARKET contains valuable insight on the benefit design innovations, marketing tactics and legal challenges being faced by Blues plans in the individual (non-group) commercial health plan market. This report features enrollment data, exclusive insight from Blues executives on balancing premiums against rising medical costs, and detailed analysis of coverage rescission issues. ($84) PDF version also available.
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 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 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 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)
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)
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.
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)
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.
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.
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.
Recordings of Past Audioconferences WHAT A ‘PUBLIC OPTION’ WOULD MEAN FOR HEALTH PLANS, a recording of a 90-minute audioconference held on June 30, 2009. Get an inside view of what a public health insurance option might look like, what impact it would likely have on health plan operations, enrollments and revenues, and what private carriers can do to survive — from Scott Keefer, vice president of policy development for the Center for Policy and Research at America’s Health Insurance Plans (AHIP), and Diane Archer, an attorney and co-director of the Health Care for All Project at the Institute for America’s Future. ($329)
UPCOMING MEDICARE REFORMS: RISKS AND OPPORTUNITIES FOR HEALTH PLANS, a recording of a 90-minute audioconference held on February 19, 2009. Hear from Gorman Health Group’s John Gorman and Jean LeMasurier about what you can expect from the Obama administration’s Medicare reforms, and steps you should consider taking to enhance your competitive position. ($329)
WALL STREET’S 2009 OUTLOOK FOR HEALTH PLANS: PROGNOSIS FOR THE INDUSTRY AND INDIVIDUAL PLANS, a recording of a 90-minute audioconference held on January 15, 2009. Get an inside view from three top health industry securities and financial analysts on how health plans are likely to perform in 2009, and how that should impact your business strategies. Speakers are: Carl McDonald, an executive director and senior analyst at Oppenheimer & Co., Shellie Stoddard, a director in insurance ratings at Standard & Poor’s, and Matthew Coffina, an equity analyst at Morningstar, Inc. ($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)
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)
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)
MEDICAL TOURISM: STRUCTURING A PROGRAM THAT BENEFITS THE HEALTH PLAN AND PATIENT, a CD of a 90-minute audioconference held on August 7, 2007. Find out how to set up or access a medical-tourism program that satisfies the needs of patients and health plans alike, and develop strategies to take advantage of this growing trend. Speakers are: Wouter Hoeberechts, CEO of WorldMed Assist, and David Boucher, assistant vice president for health care services at Blue Cross and Blue Shield of South Carolina. ($322)
SPECIALTY INFUSION MANAGEMENT: EFFECTIVE STRATEGIES FOR HEALTH PLANS, a CD of a 90-minute audioconference held on July 18, 2007. Find out how health plans are managing infusibles, and how new drugs in the pipeline and proposed federal legislation could severely impact the bottom lines of commercial and Medicare health plans. Speakers are: David Willcutts, chief executive officer at Ancillary Care Management, Inc., and Bruce Rodman, M.B.A., vice president, health information policy for the National Home Infusion Association. ($322)
THE RETAIL CLINIC BOOM: BOTTOM-LINE OPPORTUNITIES FOR HEALTH PLANS, a CD of a 90-minute audioconference held on June 28, 2007. Learn how health plans can take advantage of financial and clinical benefits resulting from the growing proliferation of walk-in clinics — from Louise Clyde, director of allied network management at Blue Cross and Blue Shield of Minnesota, Christopher W. Kersey, M.D., chief business development officer and chief medical officer of RediClinic, and Mary Kate Scott, CEO of consulting firm Scott & Company. ($322)
EFFECTIVE ONCOLOGY MANAGEMENT STRATEGIES FOR HEALTH PLANS, a CD of a 90-minute audioconference held on March 20, 2007. Learn how to design flexible programs that manage out-of-control oncology drug costs without compromising patient outcomes — from Robin U. Smith, president of Biologics, Inc., and Al Heaton, director of pharmacy at Blue Cross Blue Shield of Minnesota. ($322)
MANAGING RHEUMATOID ARTHRITIS: STRATEGIES FOR HEALTH PLANS, a CD of a 90-minute audioconference held on December 7, 2006. Find out promising ways to improve outcomes and reduce costs, which should trend even higher with expensive new RA drugs in the pipeline. Speakers are Helen Sherman, R.Ph., Pharm.D., director of pharmacy services at The Regence Group's RegenceRx, and Debbie Stern, R.Ph., vice president of managed care consulting firm Rxperts. ($292)
IDENTITY THEFT AND HEALTH CARE: 5 IMMEDIATE STEPS TO TAKE IN THE EVENT OF A SECURITY BREACH, a CD of a 90-minute audioconference held on May 16, 2006. Privacy and data security specialist Reece Hirsch details the steps you can take to limit your liability in the event of a breach, as well as strategies that can help you avoid damaging security breach incidents. ($292)
PART D VS. PART B: HOW TO SOLVE COMPLEX COVERAGE & BILLING PROBLEMS, a CD of a two-hour audioconference held on April 27, 2006. Gorman Health Group's Babette S. Edgar, Wendy Weingart and Sharon M. Durfee discuss how to determine the correct coverage for Part B-only drugs, Part D-only drugs, and D vs. B “crossover” drugs, so you can head off compliance problems and save your organization from lost reimbursement. ($292)
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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