Next-Generation Specialty Pharmacy Management Strategies for Health Plans


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Special Needs Plans: Market Strategies and Data

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Price: $69
Pages: 143
PDF Version: 899 KB
ISBN:
1-933801-34-4
© 2008
Pub Code: BSNP
 
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More than 1 million lives were enrolled in Medicare Special Needs Plans (SNPs) as of October 2007, and the number of SNPs being offered by insurers has surged to almost 500 in just a few short years. 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.

This valuable report is packed with articles that examine the processes by which health plans decide to expand their SNP operations and the subsequent successes or roadblocks. You’ll gain insight into the lessons they learned along the way, including cost, compliance and marketing strategies. Plus, a section of the report thoroughly describes CMS’s and other federal government oversight of SNPs.

Special Needs Plans: Market Strategies and Data also features a comprehensive directory of SNPs and enrollment as of fourth quarter 2007, highlighting the emerging and dominant players — and containing more than 50 pages of contact information and enrollment data!

Order your copy of Special Needs Plans: Market Strategies and Data today, and get the information you need to be a successful player in this increasingly competitive market.

Table of Contents

SNP Enrollment Trends

  • Enrollment Time Nears, Spurring Systems Challenges, Conversion of Dual Eligibles
  • Enrollment Nears 500,000 in Special Needs Plans; Big Growth Seen for ’07, CMS Says
  • SNP Enrollment Tops 500,000; P.R., Pa. Plans Post Highest Figures
  • XLHealth Says Enrolling 100 per Day Into SNP Is Good News, and Numbers Are Likely to Rise
  • Initial 2007 Enrollment Appears on Track, Especially With SNPs, Say MA Plans
  • Special Needs Plan Enrollment Nears 1 Million, But Many Could Be Migrating From MA-PDs

SNP Expansion and New Products

  • Two MCOs Edge Closer Toward Becoming MA Special Needs Plans
  • Ky. Medicaid HMO to File for SNP, Seeking Better Care, Lower Costs
  • CMS: SNP Approvals Soar, 100 New MA Filings Expected in February 2005
  • CMS Reports Surge in MA Applications, Driven by Special Needs Plans, Local Options
  • Ore. Medicaid MCO Plans To Spend $2 Million to Launch SNP in ’06
  • Special Needs Plans Multiply; 13 Chronic Care Plans Approved
  • Competing Insurers in R.I. Link to Offer MA Special Needs Plan
  • HIV/AIDS SNP Begins Coverage After Gaining Licensure From State
  • AMERIGROUP, Cariten Eye More SNPs For ’07, but Sun Health Is Waiting Until ’08
  • CMS Likely to Approve 250 SNP Applications for 2007
  • Evercare, Erickson Look to Add ’07 SNPs, Create MA Array in Retirement Communities
  • UCare to Offer MA SNP in ’07, Focus on Selling ‘Value, Not Cost’
  • CMS Unveils Big Hike in MA Plans for ’07, Including More SNPs
  • Medicaid MCO Shows Good Fourth Quarter ’06 Gains, Start SNPs
  • AMERIGROUP to Add ’08 SNPs, Citing Ample Growth Opportunity
  • N.Y. PACE Program Expands, Adds SNP, Medicaid LTC Plan
  • United, XLHealth Plan Major Expansions in Chronic Care SNPs
  • Chronic SNPs Take Off for ’08
  • Expect Rising Number of SNPs in ’08 Market, CMS Says
  • Senior Whole Health Expands in SNPs
  • SNP Expansion in Brief

SNP Strategies, Challenges and Results

  • Evercare Focuses on SNPs, Grows Into Nearly $1 Billion Business
  • Evercare 2006 Growth Strategy Focuses on SNPs
  • Evercare, Erickson SNP Plans Targeted to Retirement Communities
  • SNP Alliance Urges Payment, Quality, Integration Reforms
  • On Lok Holds Off on SNP Launch, But Other PACE Plans Move Ahead
  • Alliance Seeks Separate Bids to Show SNPs’ Total Costs
  • United Cites ‘Zero Tolerance,’ Temporarily Halts SNP’s Sale
  • Impending Shift to 100% Risk Adjustment May Deliver Big Pay Hike to Disease SNPs
  • Affinity, CHPW’s New SNPs Struggle to Find, Keep Members
  • Safety-Net Plans Work on SNPs, Aim to Add Several More in 2008
  • Some SNP Sponsors Are Finding Networks Are Insufficient to Reach Enrollment Targets
  • ‘Mom-and-Pop’ SNPs May Want to Stay Lean, But That Makes Them Vulnerable, Actuary Says
  • Health Net’s ‘Preventive’ SNP Attracts Capitol Hill Criticism
  • QMed Financial Woes Lead Partner to Move Forward Alone With SNP
  • Other SNP Sponsors Could Follow in QMed’s Wake, Consultant Says

CMS Initiatives and Federal Legislation

  • Group Urges CMS to Assist in Small Medicaid Plans’ SNP Start-up Costs
  • CMS Tells SNPs to Use Caution in Passive Enrollment, Urges Plans to Detail How They Meet Each Criterion
  • CMS Call Letter Could Aid SNPs on Duals
  • CMS Broadens SNPs’ Marketing, Lets Providers Mail SNP Promos
  • CMS’s Phase-out of Frailty Factor Said to Jeopardize Some MA Plans
  • SNPs Claim Payment Pressures, No Incentives to Care for Sickest
  • CMS Won’t Accept 2009 SNP Applications, Says It Will Issue Guidance by Mid-January 2008.

SNP Data and Enrollment Statistics
Directory of Special Needs Plans

 

Written By

This book was written by the editorial staff of AIS.

 

Written For

  • Health plan CEOs, CFOs, chief operating officers, product development and marketing executives, pharmacy directors, government relations executives, and provider network and contracting managers.

  • Directors of managed care contracting.

  • Pharmaceutical company executives and marketers.

  • Executives of pharmacy benefit management companies.

  • Attorneys and consultants.

 

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Related Publications

Medicare Advantage News
Managed Medicare and Medicaid Factbook
Medicare Part D Compliance News
Health Plan Week
Health Plan Facts, Trends and Data
Drug Benefit News
Medicaid Compliance News
AIS's Directory of Health Plans

 

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Related Publications

Medicare Advantage News

Managed Medicare and Medicaid Factbook

Medicare Part D Compliance News

Health Plan Week

Health Plan Facts, Trends and Data

Drug Benefit News

Medicaid Compliance News

AIS's Directory of Health Plans

 


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