The AIS Guide to Blue Cross and Blue Shield Plans: 2010

Webinars on: Conducting Internal Investigations; Electronic Health Records; Star Ratings for Medicare Quality Bonuses; Medication Therapy Management


AISHealth.com - Specialized Business Information for Health Care Managers Health Reform Pharmacy Benefit Consumer-Directed Care Compliance Market Data Health Plans
 HOME
 New on the Site
Customer Service
Sample Newsletters MarketPlace
AIS Products & Services

Search AISHealth.com

View Cart

Call AIS's Customer Service Department at 800-521-4323

 

Free Report: Strategies to Reduce Oncology Care Costs -- Without Sacrificing Outcomes

AIS's Health Reform Week - Informing savvy business leaders in health care of what reform means to them ... and how to take advantage of new opportunities ahead

Hot Products

New
The AIS Guide to Blue Cross and Blue Shield Plans*

Managed Medicare and Medicaid Factbook: 2010

Special Needs Plans: Regulatory Challenges and Market Strategies

Health Reform’s Impact on Commercial and Medicare Health Plans

*Not affiliated with the Blue Cross Blue Shield Association or its member companies.

Best Sellers
AIS's Directory of Health Plans: 2010

Report on Patient Privacy and AIS's HIPAA Compliance Center

2000-2009 Survey Results: Pharmacy Benefit Trends & Data

Guide to Managing Never Events and HACs

See full listing
of products at
AIS Marketplace

New on AISHealth.com: Upcoming Health Business Meetings & Health Business Job Openings

Free Report: Strategies to Reduce Oncology Care Costs -- Without Sacrificing Outcomes

AIS's Health Reform Week - Informing savvy business leaders in health care of what reform means to them ... and how to take advantage of new opportunities ahead

Hot Products

New
The AIS Guide to Blue Cross and Blue Shield Plans*

Managed Medicare and Medicaid Factbook: 2010

Special Needs Plans: Regulatory Challenges and Market Strategies

Health Reform’s Impact on Commercial and Medicare Health Plans

*Not affiliated with the Blue Cross Blue Shield Association or its member companies.

Best Sellers
AIS's Directory of Health Plans: 2010

Report on Patient Privacy and AIS's HIPAA Compliance Center

2000-2009 Survey Results: Pharmacy Benefit Trends & Data

Guide to Managing Never Events and HACs

See full listing
of products at
AIS Marketplace

New on AISHealth.com: Upcoming Health Business Meetings & Health Business Job Openings

 

Call AIS's Customer Service Department at 800-521-4323

Call AIS's Customer Service Department at 800-521-4323

 

Free Report: Strategies to Reduce Oncology Care Costs -- Without Sacrificing Outcomes

AIS's Health Reform Week - Informing savvy business leaders in health care of what reform means to them ... and how to take advantage of new opportunities ahead

Hot Products

New
The AIS Guide to Blue Cross and Blue Shield Plans*

Managed Medicare and Medicaid Factbook: 2010

Special Needs Plans: Regulatory Challenges and Market Strategies

Health Reform’s Impact on Commercial and Medicare Health Plans

*Not affiliated with the Blue Cross Blue Shield Association or its member companies.

Best Sellers
AIS's Directory of Health Plans: 2010

Report on Patient Privacy and AIS's HIPAA Compliance Center

2000-2009 Survey Results: Pharmacy Benefit Trends & Data

Guide to Managing Never Events and HACs

See full listing
of products at
AIS Marketplace

New on AISHealth.com: Upcoming Health Business Meetings & Health Business Job Openings

Call AIS's Customer Service Department at 800-521-4323

Hot Products

New
The AIS Guide to Blue Cross and Blue Shield Plans*

Managed Medicare and Medicaid Factbook: 2010

Special Needs Plans: Regulatory Challenges and Market Strategies

Health Reform’s Impact on Commercial and Medicare Health Plans

*Not affiliated with the Blue Cross Blue Shield Association or its member companies.

Best Sellers
AIS's Directory of Health Plans: 2010

Report on Patient Privacy and AIS's HIPAA Compliance Center

2000-2009 Survey Results: Pharmacy Benefit Trends & Data

Guide to Managing Never Events and HACs

See full listing
of products at
AIS Marketplace

New on AISHealth.com: Upcoming Health Business Meetings & Health Business Job Openings

Free Report: Strategies to Reduce Oncology Care Costs -- Without Sacrificing Outcomes

AIS's Health Reform Week - Informing savvy business leaders in health care of what reform means to them ... and how to take advantage of new opportunities ahead

Call AIS's Customer Service Department at 800-521-4323

Hot Products

New
The AIS Guide to Blue Cross and Blue Shield Plans*

Managed Medicare and Medicaid Factbook: 2010

Special Needs Plans: Regulatory Challenges and Market Strategies

Health Reform’s Impact on Commercial and Medicare Health Plans

*Not affiliated with the Blue Cross Blue Shield Association or its member companies.

Best Sellers
AIS's Directory of Health Plans: 2010

Report on Patient Privacy and AIS's HIPAA Compliance Center

2000-2009 Survey Results: Pharmacy Benefit Trends & Data

Guide to Managing Never Events and HACs

See full listing
of products at
AIS Marketplace

New on AISHealth.com: Upcoming Health Business Meetings & Health Business Job Openings

Free Report: Strategies to Reduce Oncology Care Costs -- Without Sacrificing Outcomes

AIS's Health Reform Week - Informing savvy business leaders in health care of what reform means to them ... and how to take advantage of new opportunities ahead

Hot Products

New
The AIS Guide to Blue Cross and Blue Shield Plans*

Managed Medicare and Medicaid Factbook: 2010

Special Needs Plans: Regulatory Challenges and Market Strategies

Health Reform’s Impact on Commercial and Medicare Health Plans

*Not affiliated with the Blue Cross Blue Shield Association or its member companies.

Best Sellers
AIS's Directory of Health Plans: 2010

Report on Patient Privacy and AIS's HIPAA Compliance Center

2000-2009 Survey Results: Pharmacy Benefit Trends & Data

Guide to Managing Never Events and HACs

See full listing
of products at
AIS Marketplace

New on AISHealth.com: Upcoming Health Business Meetings & Health Business Job Openings

Call AIS's Customer Service Department at 800-521-4323

 

AIS MarketPlace

Newsletters

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 HEALTH REFORM WEEK is a weekly newsletter that delivers timely, reliable news and sound strategies to help health care managers reinvent their business and protect their bottom line. A subscription provides business executives with a steady stream of sharp ideas from top managers with plans and providers alike ... along with special insight from policymakers and how-to guidance by top consultants and attorneys in each market. 45 issues annually ($365 for 1-year Charter Subscription); includes print copy and e-mail delivery.
More Information

Order Now


THE AIS REPORT ON BLUE CROSS AND BLUE SHIELD PLANS, valuable news and penetrating analysis of new products, market share, strategies, conversions, financing, profitability and strategic alliances of Blue Cross and Blue Shield plans. Written by insightful managed care writer/analyst Jill Brown. (Published independently by AIS. 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.) 12 issues annually ($477 per year) or 2-month intro ($72 for 2 issues); both include print copy and e-mail delivery.
More Information

Order Now


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.
More Information

Order Now


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.
More Information

Order Now


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.
More Information and Order Now


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.
More Information

Order Now


MEDICARE PART D NEWS, monthly news and strategies to help you increase Part D enrollment and boost revenues while complying with complex CMS and state enforcement actions and regulations. You’ll also 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.
More Information

Order Now


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.
More Information

Order Now



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 32 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.)
More Information and Order Now


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.
More Information

Order Now


Web Services &
Looseleaf Guides

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).
More Information

Order Now


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)
More Information

Order Now

Books and Reports &
Directories and Databases


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.

10 INDUSTRY-CHANGING TRENDS ON THE PHARMACY BENEFIT HORIZON identifies and provides all the details of 10 major trends that are changing (or should soon alter) the shape of pharmacy benefit management, from discount Rx programs to follow-on biologics to personalized medicine ... and much more. ($124) PDF version also available.
More Information

Order Now


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)
More Information

Order Now


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)
More Information

Order Now


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 Blue Cross Blue Shield Association or any of the independent Blue Cross and Blue Shield companies.) ($427) CD version also available.
More Information

Order Now


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)
More Information

Order Now

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)

More Information

Order Now


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, so you can easily create the specific kind of analysis best suited to your needs. ($652)
More Information

Order Now


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)
More Information and Order Now

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)
More Information

Order Now


CMS’s PART D AUDIT FINDINGS: A ROADMAP FOR PLAN SPONSORS, a collection of summaries of CMS’s recent audit reports that will help Part D plans avoid becoming agency targets. It highlights the top five audit hot spots and other areas that CMS and Medicare Drug Integrity Contractors have been focusing on — and will likely continue to focus on — during audits. ($84) PDF version also available.
More Information

Order Now


COMPLYING WITH THE MENTAL HEALTH PARITY AND ADDICTION EQUITY ACT provides insight for health plans and plan sponsors into the Mental Health Parity and Addiction Equity Act’s legal requirements. Written by experienced health benefits attorneys John R. Hickman, Esq., and Laurie Kirkwood, Esq., of the law firm of Alston & Bird, LLP, the book provides hands-on guidance for making complicated benefit design decisions that comply with the parity requirements. ($179)
More Information

Order Now


HEALTH INSURANCE PLAN-DESIGN TRENDS FOR GROUP AND INDIVIDUAL MARKETS contains valuable insight and examples from health insurers, brokers and agents, employers and other industry observers on how the changing needs of employers are being met. This report takes a comprehensive look at how new plan designs are altering the employee benefits landscape, and examines trends among employers, individual health plans, account-based plans, wellness programs and other disease management initiatives. ($84) PDF version also available.
More Information

Order Now


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)
More Information

Order Now


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.
More Information

Order Now


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.
More Information

Order Now


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.
More Information

Order Now


HEALTH REFORM’S IMPACT ON COMMERCIAL AND MEDICARE HEALTH PLANS addresses administrative challenges posed by the reform law, and delves into the likely impact of the act on coverage, benefit designs, medical costs and pharmacy benefits. In this report, insiders close to HHS and in leadership positions at health plans, provider organizations and PBMs spell out what form the rules might take — and who will be the winners and losers. ($84) PDF version also available.
More Information

Order Now


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)
More Information and Order Now


MANAGED MEDICARE AND MEDICAID FACTBOOK, a valuable resource with information on rates, benefit designs, enrollment, contacts, trends and strategies on the Medicare Advantage, Medicare Part D and managed Medicaid programs. Conveniently tracks the enrollment trends, plan design information and market share statistics you need in the strategic planning process. Written and organized by AIS's experienced health reporting staff. ($443) Expanded CD version also available.
More Information

Order Now


MEDICAID COMPLIANCE STRATEGIES FOR HOSPITALS AND OTHER PROVIDERS: How to Prepare for Federal Health Reform Mandates and State Initiatives is filled with articles that will help Medicaid providers understand what to expect when state or federal auditors come calling, and show how certain facilities handled major cases and settlements. This report focuses on a variety of compliance challenges, regarding Medicaid Integrity Contractors (MICs) and Recovery Audit Contractors (RACs), provider self-audits, data mining and more. ($84) PDF version also available.
More Information

Order Now


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)
More Information

Order Now


MEDICARE PLAN MARKETING IN THE REGULATORY CROSSHAIRS: NEW ENFORCEMENT INITIATIVES provides information on meeting current — and future — rules from CMS and the HHS Office of Inspector General on marketing of Medicare Advantage and Part D plans. This report includes details of new requirements, what proposed new regulations are likely to mean for enforcement in the future, and lessons learned from regulatory actions already taken against violators. ($84) PDF version also available.
More Information

Order Now


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)
More Information

Order Now


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.
More Information

Order Now


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.
More Information

Order Now


SPECIAL NEEDS PLANS: REGULATORY CHALLENGES AND MARKET STRATEGIES answers questions about major developments in Medicare Advantage Special Needs Plans (SNPs) during the past few years, from both a business and regulatory standpoint. Find out what the most successful SNPs are doing, what problems other SNPs are running into, and what impact the health reform law will have on SNPs. The report also includes a comprehensive directory of SNPs and their enrollment. ($84) PDF version also available.
More Information

Order Now


SPECIALTY PHARMACY: STAKEHOLDERS, STRATEGIES AND MARKETS, a comprehensive picture of the specialty pharmacy marketplace. Includes hard data and statistics on the vendors serving this health care sector, the products involved, and the strategies employed by payers for managing and delivering these products to members. ($341) CD version also available.
More Information

Order Now


STRATEGIES TO REDUCE ONCOLOGY CARE COSTS — WITHOUT SACRIFICING OUTCOMES covers leading oncology management strategies and pricing methodologies that can help rein in costs, yet still improve overall quality and efficiency of care. This report is filled with practical examples on ways to manage oncology therapies and details of the innovative steps some health plans already have taken ... and what results they’ve achieved. ($69) PDF version also available.
More Information

Order Now


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.
More Information

Order Now

Webinars

Upcoming Webinars
Recordings of Past Webinars

Webinars are listed below in reverse chronological order,
with the most recent first.

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.

Upcoming Webinars

HOW MORE ROBUST MEDICATION THERAPY MANAGEMENT CAN IMPROVE OUTCOMES AND LOWER COSTS, a 90-minute Webinar on September 28, 2010. Find out what steps payers are taking to comply with the new MTM requirements in the health care reform law, and what results they have achieved so far in their Medicare and commercial lines of business. You’ll hear innovative strategies for creating better MTM programs from Brand Newland, Pharm.D., vice president of Outcomes Pharmaceutical Health Care, Laurie Amirpoor, Pharm.D., staff vice president of clinical program policy at WellPoint, Inc., and Marissa Schlaifer, R.Ph., pharmacy affairs director at the Academy of Managed Care Pharmacy (AMCP). ($329)
More Information

Order Now


STAR RATINGS FOR MEDICARE QUALITY BONUSES: STRATEGIES FOR A NEW ERA OF PERFORMANCE-BASED MEASUREMENT, a 90-minute Webinar on September 21, 2010. Find out how to succeed in the star-rating system. John Gorman, founder and CEO of Gorman Health Group, LLC, and Frank Ingari, CEO of Essence Healthcare, will pinpoint the kinds of operational and clinical process elements needed to boost star ratings and earn the bonus dollars that can be the key to surviving in the post-reform era. ($329)
More Information

Order Now


COMPLIANCE PITFALLS TO AVOID WHEN IMPLEMENTING ELECTRONIC HEALTH RECORDS, a 90-minute Webinar on September 16, 2010. Learn what strategies hospitals and providers should use to limit their compliance risks when implementing an electronic health records system — from Bobbi Bonnet, national practice leader for health information management compliance at Kaiser Permanente. ($329)
More Information

Order Now


PROVEN STRATEGIES FOR CONDUCTING INTERNAL INVESTIGATIONS, a 90-minute Webinar on September 14, 2010. Learn how to set up an effective process to investigate and respond appropriately to employee complaints, including tips for successful interviewing and gathering all the information and evidence needed to assess, act on and resolve potentially complex workplace problems — from former HHS Inspector General Richard Kusserow, who is now CEO of Strategic Management Systems, LLC. ($329)
More Information

Order Now



Recordings of Past Meetings

INSURANCE EXCHANGES: HOW TO PREPARE FOR THEIR IMPACT ON SMALL-GROUP AND INDIVIDUAL MARKETS, a 90-minute Webinar first held on August 31, 2010. Find out how the state insurance exchanges called for by the health reform law are likely to impact the individual and small-group markets, and what steps you should take to get ready. The panel for this roundtable discussion includes industry insiders Rob Mercado, vice president, technology products and services at eHealth Inc., Vince Ashton, executive director of the New York Health Purchasing Alliance (HealthPass New York), Bruce Caswell, president and general manager of the health services segment at MAXIMUS, and Timothy Stoltzfus Jost, J.D., who holds the Robert L. Willett Family Professorship of Law at the Washington and Lee University School of Law. CD or On-Demand Recording available. ($329)
More Information and Order Now


MAJOR NEW HIPAA RULES ISSUED: LEARN WHAT STEPS YOU NEED TO TAKE SOON, a 90-minute Webinar first held on August 18, 2010. Learn what specific steps your organization will have to take soon to incorporate the new rules into your existing HIPAA privacy and security compliance programs. Veteran HIPAA attorney Reece Hirsch, with Morgan, Lewis & Bockius LLP in San Francisco, will summarize the major new requirements (and pitfalls) in these mammoth new regs, and what you will need to do to comply. CD or On-Demand Recording available. ($329)
More Information and Order Now


REFORM-DRIVEN CHANGES TO RETIREE HEALTH COVERAGE: STRATEGIES FOR PART D PLANS AND EMPLOYERS, a 90-minute Webinar first held on July 28, 2010. Learn how upcoming changes for retiree coverage, as mandated in the new health reform law, can benefit employers and Part D plans. Employee benefits experts from The Segal Company — Stuart Wohl, senior vice president and retirement health practice lead, and George Bognar, lead pharmacy benefits consultant — will detail the changes in the retiree drug subsidy (RDS) and the Part D coverage gap, and ways Part D plans can make the most of these opportunities. CD or On-Demand Recording available. ($329)
More Information and Order Now


ACCOUNTABLE CARE ORGANIZATIONS: STRATEGIES FOR HEALTH PLANS AND PROVIDERS, a 90-minute Webinar first held on July 21, 2010. Learn what payers and providers can do now to prepare for the new Medicare ACO pilot created by the health reform law. Joe Gifford, M.D.,  senior medical director for Regence BlueShield, and Philip Gaziano, M.D., a medical director and executive board member for Hampden County Physician Associates, LLC (HCPA), will describe current ACO models already operating in the private sector, and answer questions about how to structure and prepare to launch ACO programs soon. CD or On-Demand Recording available. ($329)
More Information and Order Now


WALL STREET OUTLOOK: HOW HEALTH PLANS ARE EXPECTED TO PERFORM IN THE SECOND HALF OF 2010, a 90-minute Webinar first held on July 15, 2010. Hear the specifics of what Wall Street expects from health plans during the next six months and how your strategies for the rest of 2010 and 2011 should be adjusted accordingly — from Carl McDonald, a director and senior analyst covering the managed care industry at Citi Investment Research, Joseph Marinucci, a director and health sector specialist for the S&P Financial Institutions Group, and Matthew Coffina, an equity analyst with Morningstar, Inc. CD or On-Demand Recording available. ($329)
More Information and Order Now


GRANDFATHERING UNDER HEALTH REFORM: STRATEGIES FOR HEALTH PLANS AND EMPLOYERS, a 90-minute Webinar first held on July 8, 2010. Learn how the regulations on grandfathering provisions in the health reform law will impact health plans and employers. Get insider perspectives on key questions about the new rules from Chantel Sheaks, a principal of Government Affairs in the National Technical Resources Group of Buck Consultants, and Kathryn Bakich, a senior vice president and national director of health care compliance at The Segal Company. CD or On-Demand Recording available. ($329)
More Information and Order Now


MEDICARE PLAN MARKETING FOR FALL 2010: STRATEGIES TO FIT THE HUGE CHANGES AHEAD, a 90-minute Webinar first held on June 23, 2010. Find out what Medicare Advantage and Part D marketing strategies your plan should consider to prepare for the upcoming enrollment season, amid the most challenging and complicated Medicare marketing environment in history. Speakers are: Dennis Barnes, founder and president of Marketing Direct, Inc. (MDI), and Jeff White, vice president, marketing and development of Physicians Health Choice. CD or On-Demand Recording available. ($329)
More Information and Order Now


MEDICARE DATA VALIDATION: PREPARING YOUR DATA FOR UPCOMING CMS AUDITS, a 90-minute Webinar first held on June 22, 2010. Learn best practices for examining and testing your reporting systems — and correcting any deficiencies — to make sure your 2010 datasets are ready to be audited in 2011. Dorothy DeAngelis, Richard Merino and Tim Nugent of FTI Consulting detail the steps plans need to take to avoid future financial and enforcement risks. CD or On-Demand Recording available. ($329)
More Information and Order Now


THE IMPACT OF REFORM ON BROKERS AND AGENTS, a 90-minute Webinar first held on June 10, 2010. Learn how reform provisions such as the MLR floor and insurance exchanges will affect future business for brokers and agents. Scott Leavitt, owner of Scott Leavitt Insurance & Financial Services, Donald Garlitz, a benefit consultant with FirstWest Benefit Solutions, and John Prible, vice president of federal government affairs at the Independent Insurance Agents and Brokers of America, Inc. (IIABA), will provide perspectives on strategies agents and brokers should employ to protect their bottom line and job security. CD or On-Demand Recording available. ($329)
More Information and Order Now


HOW TO INTEGRATE FDA RISK EVALUATION AND MITIGATION STRATEGY REQUIREMENTS INTO FORMULARY MANAGEMENT, a 90-minute Webinar first held on June 2, 2010. Learn about aspects of REMS that plans, specialty pharmacies and PBMs should incorporate into their utilization management programs to improve patient health and collect valuable outcomes data – from Lynn Nishida, director of clinical pharmacy services for RegenceRx, and Craig Kephart, president and CEO of Centric Health Resources, Inc. CD or On-Demand Recording available. ($329)
More Information and Order Now


THE REGULATION OF MEDICAL LOSS RATIOS: MAJOR CHANGES HEALTH PLANS SHOULD DESIGN NOW, a 90-minute Webinar first held on May 25, 2010. Learn what federal MLR rules are likely to include, the impact these rules have had in states such as New Jersey that already require MLR floors and rebates to consumers, and steps insurers should take to prepare for this major change in how they will need to operate soon. Speakers are: Thomas A. Carroll, a managing director at Stifel Nicolaus, and Robert Meehan, vice president of consumer and senior markets at Horizon Blue Cross Blue Shield of New Jersey. CD or On-Demand Recording available. ($329)
More Information and Order Now


HOW TO INCORPORATE OVER-THE-COUNTER DRUGS INTO PAYER FORMULARIES TO REDUCE COST AND IMPROVE ADHERENCE, a 90-minute Webinar first held on May 18, 2010. Learn about value-based insurance design, and OTC management strategies that can contain increasing prescription drug costs, improve patient adherence, monitor patient behavior and track utilization — from A. Mark Fendrick, M.D., a professor of internal medicine in the School of Medicine and a professor of health management and policy in the School of Public Health at the University of Michigan, Michael G. Cartier, Pharm.D., executive vice president of Envision Pharmaceutical Services, Inc., and Tara Higgins, a clinical pharmacist with Blue Cross & Blue Shield of Rhode Island (BCBSRI). CD or On-Demand Recording available. ($329)
More Information and Order Now


BIOSIMILAR DRUGS: PAYER STRATEGIES TO PREPARE FOR THEIR UPCOMING MARKET IMPACT, a 90-minute Webinar first held on May 13, 2010. Get the details of what health plans, employers, specialty pharmacies and PBMs can expect from the new biosimilars market, and how they can incorporate these drugs into their product design and management strategies — from three industry experts: Steve Miller, M.D., senior vice president and chief medical officer in research and clinical sciences for Express Scripts, Inc.; Mark S. Armstrong, a member of the Health Care and Life Sciences practice of Epstein Becker Green Wickliff & Hall in the firm's Houston office; and Helen Sherman, Pharm.D., senior director of pharmacy services and chief pharmacy officer at The Regence Group's RegenceRx. CD or On-Demand Recording available. ($329)
More Information and Order Now


HEALTH REFORM’S IMPACT ON MEDICARE ADVANTAGE AND PART D: STRATEGIES TO IMPLEMENT NOW, a 90-minute Webinar first held on April 26, 2010. Find out how MA reform will impact plans and their partners, and what steps you should take now and in the future to deal with the huge changes ahead — from two experts on the reform law and its implications for health plan business strategies, Bruce Merlin Fried, a partner in the national Health Care and Public Law & Policy Strategies groups at law firm Sonnenschein Nath & Rosenthal LLP, and John Gorman, founder and CEO of Gorman Health Group, LLC. CD or On-Demand Recording available. ($329)
More Information and Order Now

HEALTH REFORM MEASURES FOR 2010: URGENT CHALLENGES FOR INSURERS AND EMPLOYERS, a 90-minute Webinar first held on April 20, 2010. Find out what steps to take to prepare for health reform’s September deadlines, avoid the many administrative pitfalls ahead and position yourself for the great opportunities that will soon emerge. Chantel Sheaks, a principal of Government Affairs in the National Technical Resources Group of Buck Consultants, Fred Karutz, general manager of health plan solutions at Silverlink Communications, and Dave Tuomala, a director of actuarial consulting at Ingenix Consulting, will walk you through critical pieces of the reform law that become effective this fall. CD or On-Demand Recording available. ($329)

More Information and Order Now


NEW MEDICARE ADVANTAGE RATES: HEALTH PLAN STRATEGIES FOR BIDS DUE IN JUNE, a 90-minute Webinar first held on April 8, 2010. Get insider guidance on how to quickly incorporate the final 2011 MA rates into your product-development and bidding strategy. William A. MacBain, senior vice president, finance of Gorman Health Group, LLC, will address how your organization can prepare for the major changes facing MA sponsors. CD or On-Demand Recording available. ($329)
More Information and Order Now


HOW TO AMEND HIPAA BUSINESS ASSOCIATE AGREEMENTS TO COMPLY WITH THE HITECH ACT, a 90-minute Webinar first held on April 7, 2010. 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 … despite a lack of guidance from HHS’s Office for Civil Rights. CD or On-Demand Recording available. ($329)
More Information and Order Now


HOW TO GUARANTEE PBM TRANSPARENCY, REDUCE RX COSTS AND MAXIMIZE PHARMACY BENEFITS, a 90-minute Webinar first held on April 1, 2010. Get insider perspectives on new initiatives plans and employers are undertaking to make sure their PBM contracts contain adequate protections and are truly transparent … and the crucial strategies Rx payers should employ to achieve the lowest feasible drug spend and save millions of dollars. Speakers are: Susan Hayes, principal of Pharmacy Outcomes Specialists; Kevin Nagle, president and CEO of Envision Pharmaceutical Services, Inc.; and F. Randy Vogenberg, PhD, RPh, Principal, Institute for Integrated Healthcare. CD or On-Demand Recording available.($329)
More Information and Order Now


VENDOR GIFTS AND RELATIONS: STRATEGIES FOR REDUCING YOUR COMPLIANCE RISKS, a 90-minute Webinar first held on March 10, 2010. Learn how to identify and manage vendor gifts and relationships, and what successful strategies hospitals and other providers should incorporate into their policies and procedures that will minimize vendor gift compliance risks. Speakers are Richard Kusserow, CEO of Strategic Management Systems, Inc., and Julie Chicoine, compliance director for the Ohio State University Medical Center. CD or On-Demand Recording available.($329)
More Information and Order Now


BENEFIT DESIGN DEMANDS FROM EMPLOYERS: HEALTH PLAN CHALLENGES FOR FALL 2010, a 90-minute Webinar first held on March 9, 2010. Learn about new cost-containment strategies that large employers want, as well as programs that can successfully improve the health and productivity of their employees — from Jorge Font, a principal at Buck Consultants, and Alexander “Sander” Domaszewicz, a principal and senior consultant with Mercer Health & Benefits Services. CD or On-Demand Recording available. ($329)
More Information and Order Now


MENTAL HEALTH PARITY: HOW TO COMPLY WITH NEW FINAL REGS, a 90-minute Webinar first held on February 25, 2010. Get strategic insights on steps your organization must take to fully comply with the new parity regulations, and specific actions you can take to control costs while ensuring the availability of behavioral health care benefits – from two experts on the legislation, Rhonda Robinson Beale, M.D., chief medical officer for UnitedHealth Group subsidiary OptumHealth Behavioral Solutions, and John Hickman, Esq., head of Health & Welfare Benefits in the Employee Benefits and Executive Compensation Group at the law firm Alston & Bird, LLP in Atlanta. CD or On-Demand Recording available. ($329)
More Information and Order Now


HIPAA SECURITY BREACHES: 10 STEPS TO TAKE WHEN A BREACH OCCURS, a 90-minute Webinar first held 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. CD or On-Demand Recording available. ($329)
More Information and Order Now


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)
More Information and Order Now


HOW TO BOOST ADHERENCE WITH CHOLESTEROL DRUGS: HEALTH PLAN STRATEGIES TO IMPROVE OUTCOMES AND LOWER COSTS, a recording of a 90-minute audioconference held on January 27, 2010. Get the specifics on which strategies are most successful at boosting statin adherence, which in turn can dramatically improve patient outcomes and lower costs — from Jan Berger, M.D., chief medical officer at Silverlink Communications, and Richard A. Feifer, M.D., vice president of clinical program development for the Advanced Clinical Solutions Group at Medco Health Solutions, Inc.  ($329)
More Information and Order Now


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)
More Information and Order Now


COMPETITIVE BIDDING UNDER MEDICARE ADVANTAGE: SURVIVAL STRATEGIES FOR PLAN SPONSORS, a recording of a 90-minute audioconference held on December 3, 2009. Get vital insights on how to plan for and succeed in an MA environment based on competitive bidding, from two experts at Ingenix Consulting — Stephen P. Wood, senior vice president, and Kirk Twiss, vice president, actuarial consulting. ($329)
More Information and Order Now


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)
More Information and Order Now


MAJOR NEW REPORTING RULES FOR MA AND PART D PLANS: WHAT SPONSORS NEED TO KNOW NOW, a recording of a 90-minute audioconference held on November 17, 2009. Learn the details and implications for Medicare Advantage and Part D programs of CMS’s proposed new regs. Steve Arbaugh of ATTAC Consulting Group and Wendy Krasner of Manatt, Phelps & Phillips, LLC, provide practical guidance on what plans need to start doing immediately to avoid sanctions and penalties, and limit the significant administrative burdens ahead. ($329)
More Information and Order Now


STRATEGIES TO MANAGE SPECIALTY DRUGS IN THE MEDICAL BENEFIT, a recording of a 90-minute audioconference held on November 16, 2009. Find out how two plans have begun to manage specialty drugs in both the pharmacy and the medical benefit, and what results they are achieving. Speakers are: Donna Paine, Pharm.D., clinical pharmacy specialist at Blue Cross Blue Shield of Rhode Island; and Lynn Nishida, director of clinical pharmacy services for RegenceRx. ($329)
More Information and Order Now


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)
More Information and Order Now


PREPARING YOUR MA PLAN FOR THIS FALL’S RISK ADJUSTMENT AUDITS: STRATEGIES TO REDUCE YOUR COMPLIANCE AND FINANCIAL RISKS, a recording of a 90-minute audioconference held on October 28, 2009. Get valuable information on how to prepare for imminent and potentially very costly MA RADV audits. Anne Crawford, compliance officer of Medicare Parts C and D for Highmark Blue Cross Blue Shield, provides details on strategies you need to design and implement immediately to ensure that your processes meet CMS’s submission requirements. ($329)
More Information and Order Now


MEDICARE MEMBER RETENTION: STRATEGIES TO COUNTER ‘SWITCHER’ CAMPAIGNS FROM COMPETITORS, a recording of a 90-minute audioconference held on October 22, 2009. Gorman Health Group’s chief marketing officer, Lindsay Resnick, details how you can build a member-centric program to retain as many of your Medicare Advantage and Part D enrollees as possible before the upcoming the annual election period. ($329)
More Information and Order Now


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)
More Information and Order Now


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)
More Information and Order Now


WHAT HEALTH INSURANCE COOPERATIVES WOULD MEAN FOR HEALTH PLANS, a recording of a 90-minute audioconference held on August 12, 2009. Get practical intelligence on the health insurance co-op model and how it would affect the health insurance market. Speakers James O’Connor, a principal and consulting actuary at Milliman Inc., and Allan Wearing, sales and marketing director at Group Health Cooperative of South Central Wisconsin, answer questions about how co-ops would work and what steps private insurers should take to prepare for the possible inclusion of co-ops in health reform legislation. ($329)
More Information and Order Now


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)
More Information and Order Now


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)
More Information and Order Now


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)
More Information and Order Now


INDIVIDUAL MANDATE AND GUARANTEED ISSUE: WHAT PLANS CAN DO TO PREPARE FOR THE POTENTIALLY ENORMOUS CHANGES AHEAD, a recording of a 90-minute audioconference held on June 18, 2009. Two leading health policy experts — Rosemarie Day, deputy director and chief operating officer of the Commonwealth Health Insurance Connector Authority, and Kevin Wrege, president of PULSE Issues & Advocacy LLC and a consultant to the Council for Affordable Health Insurance — discuss the likely impact of guaranteed issue and individual mandate rules, and what health plans can do to prepare for their possible adoption. ($329)
More Information and Order Now


‘MONEY-BACK-GUARANTEES’ ON RX DRUGS: STRATEGIES FOR HEALTH PLANS AND PBMs TO ENSURE VALUE AND SAVE MONEY, a recording of a 90-minute audioconference held on June 11, 2009. Get reliable information on creating performance-based pharmaceutical contracts, and learn what your organization should do now to prepare for this emerging trend. Speakers are two of the leading architects of this concept – Christina J. Barrington, Pharm.D., director of pharmacy at Health Alliance Medical Plans, and Thomas O. Stambaugh, vice president and chief clinical officer of CIGNA Pharmacy Management. ($329)
More Information and Order Now


THE TOP 5 PART D AUDIT RISKS: HOW YOU CAN AVOID BECOMING A CMS TARGET, a recording of a 90-minute audioconference held on May 28, 2009. Dorothy DeAngelis and Richard Merino of FTI Consulting outline the areas CMS is now stressing in its Part D audits, and what preventive steps you should take to reduce your chances of strict penalties and sanctions. ($329)
More Information and Order Now


MEDICARE ADVANTAGE RATES OUTLOOK: HEALTH PLAN STRATEGIES FOR BIDS DUE ON JUNE 1, a recording of a 90-minute audioconference held on May 7, 2009. William MacBain, senior vice president, finance of Gorman Health Group, LLC, will help you develop sound strategies regarding MA payment rates in 2010 and beyond. Get answers to complex questions, including: what are the implications of the 2010 rates, what should MA plans expect for the coming year, and what should they be doing as the deadline for bids draws near? ($329)
More Information and Order Now


COMPLYING WITH THE NEW FEDERAL SECURITY BREACH NOTIFICATION LAW: STRATEGIES FOR HIPAA COVERED ENTITIES, a recording of a 90-minute audioconference held on May 5, 2009. Learn from veteran health care privacy and security attorney Reece Hirsch, a partner in the San Francisco office of the law firm of Morgan, Lewis & Bockius LLP, what the components of your federal security breach compliance program should be — and what new steps your organization should take immediately following a security breach — to comply with the rigorous new federal security breach notification law. ($329)
More Information and Order Now


NEW CMS MEDICATION THERAPY MANAGEMENT RULES: WHAT PART D SPONSORS MUST DO TO COMPLY AND SUCCEED, a recording of a 90-minute audioconference held on April 30, 2009. Learn what actions health plans and PBMs must take to comply with CMS’s tough new 2010 medication therapy management requirements. Tim Sawyers, director of clinical pharmacy services at HealthSpring, Inc., and Denise Kehoe, vice president of business development at PharmMD, will provide insight on how CMS’s rules will alter your existing MTM program, and improve members’ health and your plan’s bottom line. ($329)
More Information and Order Now


HEALTH PLAN MEMBER RETENTION STRATEGIES IN A TOUGH ECONOMY, a recording of a 90-minute audioconference held on April 22, 2009. Find out what group client retention strategies you can implement to minimize the impact of the economic meltdown — from Michael Taylor, a principal in the Towers Perrin Boston office, and Ingrid Lindberg, CIGNA Corp.’s customer experience officer. ($329)
More Information and Order Now


COMPLYING WITH CMS’S NEW ‘LOCK-IN PRICING’ RULE: IMMEDIATE STEPS PART D SPONSORS MUST TAKE, a recording of a 90-minute audioconference held on March 19, 2009. Learn to read and renegotiate contracts with PBMs, and develop mechanisms for implementing the “negotiated price” provision, to reduce your risk of severe sanctions and significant monetary penalties — from Steve Arbaugh of ATTAC Consulting Group and Susan Hayes of Pharmacy Outcome Specialists. ($329)
More Information and Order Now


MAJOR NEW HIPAA REQUIREMENTS: HOW TO COMPLY WITH STRONG PRIVACY AND SECURITY MEASURES SIGNED BY PRESIDENT OBAMA, a recording of a 90-minute audioconference held on March 11, 2009. Veteran HIPAA attorney Reece Hirsch, a partner with Sonnenschein Nath & Rosenthal LLP in San Francisco, outlines specific steps your organization must take to incorporate the groundbreaking new federal law — which contains the most significant changes to federal health care privacy and security law since the enactment of HIPAA — into your existing compliance program. ($329)
More Information and Order Now


PERSONALIZED MEDICINE: HEALTH PLAN STRATEGIES TO IMPROVE OUTCOMES AND CONTROL RX COSTS, a recording of a 90-minute audioconference held on February 26, 2009. Felix Frueh, Ph.D., vice president of research and development and personalized medicine at Medco, and Lynn Nishida, director of clinical pharmacy services for RegenceRx,will provide strategic insight on how health plans, PBMs and other stakeholders can make sense of recent developments in personalized medicine, and use the concept to improve members’ health outcomes and control pharmaceutical spending. ($329)
More Information and Order Now


DESIGNING AND MARKETING INDIVIDUAL AND SMALL-GROUP INSURANCE PRODUCTS FOR AN ECONOMIC SLOWDOWN, a recording of a 90-minute audioconference held on January 29, 2009. Learn practical steps for designing and selling health insurance products in a recession, from three experienced health insurance brokers — Scott Leavitt, owner of Scott Leavitt Insurance & Financial Services, Mark Carroll, a founding partner of Small Business Insurance Solutions (SBIS), and Joseph Dibella, an executive vice president at Conner Strong Companies, Inc. ($329)
More Information and Order Now


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)
More Information and Order Now


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)
More Information and Order Now


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)
More Information and Order Now


MEDICAL TOURISM: HEALTH PLAN STRATEGIES FOR INTEGRATING OVERSEAS NETWORKS INTO BENEFIT DESIGNS, a recording of a 90-minute audioconference held on November 6, 2008. Find out how to integrate medical-tourism benefits in a way that satisfies the needs of patients and payers alike — and the pitfalls that need to be avoided — from medical tourism experts Wouter Hoeberechts, CEO of WorldMed Assist, and Phil Midden, operations manager at Companion Global Healthcare, the medical tourism subsidiary of BlueCross BlueShield of South Carolina. ($329)
More Information and Order Now


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)
More Information and Order Now


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)
More Information and Order Now


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)
More Information and Order Now


FINDING ‘VALUE’ IN VALUE-BASED Rx BENEFITS: ROI STRATEGIES FOR HEALTH PLANS AND EMPLOYERS, a recording of a 90-minute audioconference held on September 18, 2008. Two leading experts on value-based programs — Jack Mahoney, M.D., corporate medical director and global health care management director at Pitney Bowes Inc., and Brian Sweet, chief pharmacy officer at WellPoint, Inc. — offer their strategic insights on how health plans and self-insured employers can see a significant return on investment out of their value-based insurance design (VBID) programs. ($329)
More Information and Order Now


HEALTH PLAN STRATEGIES FOR USING PREDICTIVE MODELING IN UNDERWRITING, a recording of a 90-minute audioconference held on August 26, 2008. Hear two experienced health plan executives outline how their companies use predictive modeling tools to improve the accuracy and profitability of underwriting efforts. Speakers are: Swati Abbott, president of MEDai, Inc., and Sharon Howe, director of underwriting for LifeWise Health Plans in Oregon and Arizona, subsidiaries of Premera Blue Cross. ($329)
More Information and Order Now

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)
More Information and Order Now


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)
More Information and Order Now


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)
More Information

Order Now


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)
More Information

Order Now


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.
More Information and Order Now


INNOVATIVE PROVIDER PAYMENT STRATEGY OR CAPITATION ALL OVER AGAIN? a CD of a 90-minute audioconference held on April 3, 2008. Hear a provocative debate about new provider-payment strategies health plans are experimenting with to replace the traditional fee-for-service model — from Robert Mandel, M.D., vice president of health care services at Blue Cross Blue Shield of Massachusetts, and François de Brantes, CEO for Bridges To Excellence. ($329)
More Information

Order Now


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)
More Information and Order Now


PART D ENFORCEMENT PITFALLS: HOW TO IDENTIFY AND ELIMINATE FRAUD AND ABUSE IN YOUR DOWNSTREAM ENTITIES, a CD of a 90-minute audioconference held on March 13, 2008. Find out urgent new compliance challenges Part D plans face in light of CMS’ recently finalized regs that increase sponsor responsibilities for downstream entities … and learn steps you can take to identify and eliminate fraud and abuse at the various contact points for beneficiaries. Hear from Susan Hayes, principal and founder of Pharmacy Outcome Specialists and Steve Arbaugh, principal with ATTAC Consulting Group, LLC. ($329)
More Information

Order Now


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)
More Information and Order Now


“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)
More Information

Order Now


HEALTH PLAN PAY-FOR-PERFORMANCE PROGRAMS FOR SPECIALISTS: RECENT FINANCIAL AND CLINICAL OUTCOMES, a CD of a 90-minute audioconference held on January 24, 2008. Find out how two leading health plans developed and refined their P4P programs for specialists, and learn how their successes may be applied to your P4P plans. Speakers are Bill Hauser, M.D., regional head of medical and quality management operations for Aetna, Inc.’s Southeast and Southwest regions, and Babette Apland, senior vice president of health and care management and provider relations at HealthPartners, Inc. ($329)
More Information

Order Now


HEALTH PLAN STRATEGIES FOR HIGH-TECH IMAGING TESTS, a CD of a 90-minute audioconference held on November 29, 2007. Learn specific steps you can take to address rising costs and formulate coverage polices for advanced and emerging high-tech imaging procedures (MRIs, CT scans and PET scans, CT angiography, functional MRI’s for Alzheimers’s disease) — from Ken Patric, M.D., vice president and chief medical officer at BlueCross BlueShield of Tennessee and Diane Hayes, vice president of research and development for medical technology assessment firm, Hayes, Inc. ($329)
More Information

Order Now

Place an order or get more information at 800-521-4323



Advertise With AIS

Privacy

Site Map


Copyright © 2010 by Atlantic Information Services, Inc. All rights reserved.
1100 17th Street, NW, Suite 300, Washington, DC 20036
Phone 202-775-9008 or 800-521-4323; E-mail
customerserv@aishealth.com