Changing market conditions and new government initiatives are creating huge opportunities and even bigger risks for health plans. To succeed in today's health care business, you must have an effective way to track and forecast the big-dollar issues.

Health Plan Facts, Trends and Data is full of strategic intelligence that will help you stay ahead of your competition in this constantly changing arena. It's a well-organized resource packed with:

• Health plan cost trends
• Market-specific enrollment trends
• Pharmacy benefit data and strategies
• M&A activity and conversions
• Health plan executive compensation
• Health plan financial results and growth strategies
• Provider payment innovations
• Lawsuits and consumer initiatives
• New product offerings and marketing strategies
• Product diversification and development

• State-level actions and legislation, particularly on universal health care coverage
• Educational Web sites and other tools consumers can use to make better decisions about their health care, plus technological advances in health monitoring and electronic data
• The impact of rising medical costs on health plans’ bottom lines
• Health savings accounts (HSAs), health reimbursement accounts (HRAs) and consumer-directed care plan developments, including benefit design strategies and industry players
• Pay-for-performance measures and tiered networks
• Federal health insurance reform
• Retail health clinics
• Blue Cross/Blue Shield plan trends — including a section on enrollment trends and a directory of BC/BS plans
• Disease management and other medical management issues such as imaging and obesity
• Medicare Rx and e-prescribing

Make sure you're addressing the tough challenges ahead with the best information available. Order your copy of Health Plan Facts, Trends and Data today.

Also Available on CD: For an additional $150, you can order the convenient CD edition of Health Plan Facts, Trends and Data along with the printed book. The CD contains all of the information in the print edition and you’ll find what you need instantly with the user-friendly, searchable PDF format.

Table of Contents

Chapter 1: Health Plan Industry Trends

• Mergers and Acquisitions
• Health Plan Enrollment Trends
• Costs, Premiums and Profitability
• Marketing Strategies and Partnerships
• Executive Compensation Trends

Chapter 2: Health Plan Company News and Events

• Health Plan Market Share and Market Expansions
• Company-Specific Growth Strategies
• Health Plan Financial Performance
• MCO Organizational Structure and Leadership

Chapter 3: Blue Cross Blue Shield Plan Trends and Data

• Blues Plans Trends and Strategies
• Blue Cross Blue Shield Enrollment
• Market Share and Competition
• Conversion and Nonprofit Issues
• Directory of Blue Cross Blue Shield Plans

Chapter 4: Benefit Design and Consumer-Directed Health Trends

• Limited Benefit Plans
• Health Plan Benefit Design Trends
• Specialty Benefit Design Trends and Coverage Issues
• Product Launches and Coverage Expansions
• Stop-Loss Insurance
• Consumer-Directed Health Plans
• Employer Strategies
• Financial Institution Market Impact

Chapter 5: Provider Contracting and Pay-for-Performance

• Network Administration and Contracting Issues
• Overseas Medical Tourism
• Pay-for-Performance Initiatives
• Quality Data Initiatives
• Tiered Networks

Chapter 6: Health Plan Tools and Technology

• Online and Educational Tools and Consumer Web Sites
• Electronic Records and Data Innovations
• Medical Technology Initiatives and Coverage
• Information Technology for Health Plans

Chapter 7: Health Promotion and Disease Management

• Health Plan DM Strategies
• Utilization Management
• Strategies for Specific Disease States
• Wellness Programs

Chapter 8: Pharmacy Benefit Management News and Strategies

• Pharmacy Benefit Strategies
• PBM Contracting
• Pharmacy Costs and Trends
• E-Prescribing Initiatives, Trends and Results
• Specialty Pharmacy Trends

Chapter 9: Medicare Advantage and Part D Business Strategies

• MA Participation and Enrollment
• Government Initiatives, Regulation and Funding
• Marketing Issues and Partnerships
• Product Development, Launches and Service Areas
• Special Needs Plans
• Medicare Part D Drug Benefit News and Events
• Regional Managed Medicare Marketplace Data

Chapter 10: State Health Reform Initiatives

• State Initiatives
• State-Level Universal Health Care Initiatives
• Coverage Expansions

Chapter 11: State Managed Medicaid Markets

• Managed Medicaid News and Events
• Medicaid Cost and Funding
• Medicaid Contract Awards and Strategies
• Managed Medicaid Enrollment Data

Chapter 12: Federal Regulations, Litigation and Legal Issues

• Federal Health Care Reform and Legislative Efforts
• Data Protection and Security
• Provider Issues
• Antitrust and Fraud and Abuse Issues
• Health Plan Liability and Legal Action

Chapter 13: Health Plan Directories

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

Master Table of Contents

Index of Charts

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

International orders will be fulfilled in PDF format via email.