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

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Health Plan Facts, Trends and Data: 2010-2011


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Print version: $398
Print & CD versions: $548
Pages: 362
ISBN: 1-933801-84-0
© 2010
Pub Code: GHPF15-
ENLAD


With all the unanswered questions on how to best implement provisions in the health care reform law — and how you can make these changes but still remain competitive — you need a reliable source of information on the state of the health insurance industry. Health Plan Facts, Trends and Data: 2010-2011 contains reliable reporting and analysis to help your organization plan for changes under health reform.

With more than a dozen information-packed chapters, this valuable source of relevant facts and statistics is organized so that the strategic information you need is easy to find. Health Plan Facts, Trends and Data: 2010-2011 includes in-depth coverage of:

  • The health reform debate – everything from insurance exchanges to accountable care organizations to MLRs to the effect on brokers and sales agents – plus a convenient reform implementation timeline
  • Health plan financial performance
  • Benefit design trends – including pharmacy benefit strategies, limited-benefit plans, employer initiatives and the small group and individual markets
  • Health plan company activity – such as executive compensation, enrollment, costs, premiums and profitability
  • Ways companies are tapping the small group and individual markets
  • Effect of COBRA subsidies on health plans
  • Debate over health plans’ consumer policies
  • Product development for uninsured and underinsured populations
  • Provider contracting – including network administration, reimbursement, never events and quality initiatives
  • And much more.

Get the perspective you need to make sense of the state of the health plan industry with the all-new edition of Health Plan Facts, Trends and Data: 2010-2011.

Also Available on CD: For an additional $150, you can order the convenient CD version of Health Plan Facts, Trends and Data. The CD contains all of the information in the print version and you’ll find what you need instantly with the user-friendly, searchable PDF format. Plus, all CD purchasers receive a free copy of the print version!

Table of Contents

Chapter 1: Health Plan Enrollment Trends and Market Share

  • Membership Growth and Losses
  • Enrollment Data
  • Tapping the Individual Market
  • Federal Employees Health Benefits Program

Chapter 2: Health Plan Organizational Structure and Leadership

  • Executive Compensation Trends
  • Layoffs and Work Force Issues
  • Lobbying and Donations
  • Leadership Changes and Appointments

Chapter 3: Health Plan Growth and Consolidation

  • Mergers, Acquisitions and Divestitures
  • Contract Awards
  • Product Launches and Coverage Expansions
  • Product Development for the Uninsured and Underinsured
  • Retail Insurance Stores

Chapter 4: Health Plan Financial Performance

  • Second Quarter 2009 Results
  • Third Quarter 2009 Results
  • Fourth Quarter 2009 Results
  • First Quarter 2010 Results
  • Health Plan Overall Performance
  • Stock Market Performance
  • Key Financial Data and Medical Loss Ratios

Chapter 5: Federal Health Reform

  • Implementation Timeline for Key Health Reform Provisions
  • Grandfather Rules
  • Coverage Provisions and Expansions
  • High-Risk Insurance Pools
  • Medical Loss Ratios
  • Insurance Exchanges
  • Impact on Medicaid
  • Impact on Pharmacy and Part D
  • Effect on Brokers and Sales Agents
  • Accountable Care Organizations
  • State Reaction to Reform Law
  • Industry Perspectives and Legal Challenges

Chapter 6: Benefit Design

  • Employer Initiatives
  • Small-Group and Individual Market
  • Limited-Benefit Plans
  • Medicare Advantage Products
  • Pharmacy Benefit Strategies
  • HSAs, Debit Cards and Other Financial Products

Chapter 7: Coverage Costs, Premiums and Rate-Setting

  • Health Care Costs and Spending
  • Premium Increases
  • State-Specific Rate Hikes
    • California
    • Connecticut
    • Maine
    • Massachusetts
    • New Mexico
    • New York
    • Ohio
    • Pennsylvania
    • Rhode Island
  • Effect of COBRA Subsidy on Health Plans
  • High-Risk Pools

Chapter 8: Provider Network Administration, Reimbursement and Contracting Issues

  • Network Administration and Reimbursement
  • Never-Events and Hospital Errors
  • Quality Initiatives
  • Retail Clinics
  • UCR Rates and the Ingenix Controversy

Chapter 9: Information Technology and Records Security Concerns

  • Online Tools for Consumers
  • Compliance With ICD-10
  • Using Technology to Combat Fraud
  • Personal Health Records and Data Protection Concerns
    • Data Security Breaches
  • Green Initiatives
  • Telemedicine

Chapter 10: Health Promotion, Wellness and Disease Management Strategies and Challenges

  • Wellness Intitiatives for Health Plans and Employers
  • Strategies for Specific Health Issues
    • Cancer
    • C-Sections
    • Diabetes
    • Flu
    • Multiple Sclerosis
    • Obesity
  • Genetic Information Nondiscrimination Act
  • Medical Home Models
  • Strategies for Patient Prescription Adherence

Chapter 11: Controversy Over Health Plan Consumer Policies

  • Sales and Marketing Violations and Other Communications Issues
  • Coverage Rescissions
  • Coverage Denials and Rejected Claims

Chapter 12: Health Plan Legal Challenges

  • Fraud, Antitrust and Abuse Issues
  • Health Plan Liability and Legal Actions
  • HIPAA Violations
  • Mental Health Parity Regulations
  • State-Level Legislation and Legal Battles
    • Legislation
    • Claims Issues

Chapter 13: Health Plan Resources and Directories

  • Directory of Federal and Regional Medicare Regulators
  • Directory of Health Plan Associations
  • Directory of Health Plan Trade Associations
  • Directory of Health Plan Accrediting Bodies
  • Directory of State Medicaid Directors
  • Directory of State Insurance Commissioners
  • Directory of State Health Officials

 

Written By

Health Plan Facts, Trends and Data was written and edited by the editorial staff of Atlantic Information Services.

Written For

  • Managers of HMOs, PPOs, POS plans and PSOs
  • Hospital managers and health system executives
  • Group practice managers
  • Managers of IDSs
  • Insurance executives
  • Employee benefits managers
  • Consultants and attorneys

AIS Guarantee

Order Health Plan Facts, Trends and Data for a 30-day risk-free inspection and test for yourself its value. If within 30 days you're not interested in keeping this comprehensive resource, just return it to AIS and we will send you a prompt, full refund. For CD purchasers, refunds will not be made once the seal on the CD package has been broken. Please review your copy of the print version prior to breaking the seal.

Shipping Information

This item is shipped via UPS. Please give us your street address when you order (UPS does not deliver to PO boxes.) You should receive your order within 5-7 business days. Shipping cost is $5 per item.

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Related Publications

Health Plan Week

AIS's Health Reform Week

Drug Benefit News

Medicare Advantage News

Managed Medicare and Medicaid Factbook

The AIS Report on Blue Cross and Blue Shield Plans

Pharmacy Benefit Trends & Data

AIS's Directory of Health Plans

AIS’s 2003-2007 Health Plan Enrollment Statistics

 


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