The AIS Guide to Blue Cross and Blue Shield Plans

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

Published independently by Atlantic Information Services. Not affiliated with or sponsored, endorsed or approved by the Blue Cross and Blue Shield Association or any of the independent Blue Cross and Blue Shield companies.

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Print edition: $427
Print & CD editions: $657
Pages: 248
ISBN: 1-933801-79-4
© 2010
Pub Code: GBLU2

From the publishers of the successful monthly newsletter The AIS Report on Blue Cross and Blue Shield Plans*, comes the completely updated competitive intelligence resource, The AIS Guide to Blue Cross and Blue Shield Plans: 2010*. It contains 13 information-packed chapters, with facts, trends and data about:

Medical loss ratios
Administrative spending
Reserve levels
Medical fraud recovery
Computer security breaches
Anti-competitiveness, “near-monopolies,” and RICO
Pandemic response and swine flu coverage
Mental health parity and autism
Oncology management
Online physician visits
E-prescribing initiatives
And more

Whether you count Blue Cross and Blue Shield plans as partners or competitors, The AIS Guide to Blue Cross and Blue Shield Plans contains reliable information on Blues’ products, market strategies, acquisitions and alliances. It includes financial projections and hard-to-find data on executive compensation, revenues, earnings, enrollment and medical loss ratios, plus insight into premium trends, rate hike proposals, and more. You can use this information to gain an understanding of Blues plans’ market strategies, operational tactics and cost-containment techniques.

This unique resource is the only place you can find reliable data on Blues’ history, function and structure, along with:

BCBS trade names and marketing advantages,
BCBS licensee requirements and association guidelines,
BCBS plan executive compensation stats, and
Exclusive interviews with CEOs on plan strategies, philosophies and opportunities.

*The AIS Guide to Blue Cross and Blue Shield Plans: 2010 and The AIS Report on Blue Cross and Blue Shield Plans are published independently by AIS. They are 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.

CD Version Available for Easy Data Manipulation and Fast Searching! The CD version of The AIS Guide to Blue Cross and Blue Shield Plans: 2010 is packed with data and analysis not contained in the print version such as previous year data, to allow for year-over-year comparison for many enrollment and financial data points. It includes all the data in Excel spreadsheets, so you can easily create your own analyses, as well as directory contact information, and a complete user-friendly PDF version of the book for fast searching. Plus, all CD purchasers receive a free copy of the print version!

Table of Contents

Chapter 1: What Is a Blue Cross and Blue Shield Plan?

History, Function and Structure of the Blue Cross and Blue Shield Association
BCBSA Financial Results
BCBS Trade Names and Marketing Advantages
BCBSA Licensee Requirements and Association Guidelines

Chapter 2: Corporate Leadership, Structure and Events

Corporate Growth Strategies
Mergers, Acquisitions and Divestitures
BCBS Plan Leadership and Staff Changes
Workforce Issues, Outsourcing and Downsizing
BCBS Plan Executive Compensation
Green Initiatives

Chapter 3: Enrollment Statistics and Market Share

Membership Gains and Losses
National Enrollment and Market Share for BCBS Plans
Enrollment Breakdown by Sector and Risk for BCBS Plans
Blues Enrollment and Market Share by State
Competitive Landscape in 15 Important BCBS Markets

Chapter 4: Financial Performance of BCBS Companies

Publicly Traded BCBS Organizations’ Financial Results
Not-for-Profit BCBS Organizations’ Financial Results
Cost Containment Strategies and Medical Cost Ratios
Administrative Spending
Reserve Levels
Medical Fraud Recovery
Cost and Revenue Data

Chapter 5: Growth Strategies for Specific Companies and Markets

Targeting Uninsured With Public/Private Partnerships
Individual (Non-Group) Products
Group Health Offerings and Contracts
Local Market Issues and Strategies
Medicare Advantage and Medicare Part D
Medicaid, SCHIP and Local Public Programs
TRICARE

Chapter 6: Benefit Design and Coverage Issues

Coverage Policies and Rescissions
Pandemic Response and Swine Flu Coverage
Pharmacy Benefit Strategies and Results
Mental Health Parity and Autism

Chapter 7: Premiums and Rate-Setting Issues

Premium Trends
Rate Hike Proposals, Awards and Denials
Risk Pools

Chapter 8: Health Care Reform and Lobbying

Health Reform Provisions
Health Reform Negotiations, Testimony and Lobbying Efforts
Political Donations and Lobbying Expenses
State-Level and Local Health Reform Initiatives

Chapter 9: Provider Relations, Fees and Conflicts

Alternative Quality Contracts and Global Payment Systems
Fee Schedules and Reimbursement
Never-Event Policies
Provider Incentives and Quality Data

Chapter 10: Other Legal and Regulatory Challenges

Anti-Competitiveness, “Near-Monopolies” and RICO
Antitrust Issues
Tax-Exempt Status and For-Profit Conversions
Fraud and Abuse, Corruption and Wrongdoing

Chapter 11: Wellness, Prevention and Disease Management Programs

Health Improvement Initiatives
Behavioral Health Management
Oncology Management
Medical Home Models

Chapter 12: Information Technology and Claims-Processing Issues

Operational Software and Systems
ICD-10 Implementation Strategies
Security Breaches and Issues
Online Physician Visits
e-Prescribing Initiatives

Chapter 13: Directory of Blue Cross and Blue Shield Organizations

Written By

The AIS Guide to Blue Cross and Blue Shield Plans is written and edited by the editorial staff of Atlantic Information Services.

Written For

HMOs, PPO and POS plans
Insurers
Hospitals and health systems
Group practices
Pharmaceutical companies
Other health care organizations

AIS Guarantee

Order The AIS Guide to Blue Cross and Blue Shield Plans for a 30-day risk-free inspection and test for yourself the value of this information resource. Order this comprehensive resource for a 30-day risk-free inspection and see its value for yourself. If within 30 days you are not 100% satisfied, you may return it to AIS and receive a full, prompt 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.

Rush orders: Please call us at 800-521-4323 to place a rush order. We will overnight your order for an additional charge of $30, or you can give us your FedEx or UPS account number and we will charge the shipping to your account. Rush orders placed after 3:00pm EST will not be shipped out until the next business day.

Related Publications

The AIS Report on Blue Cross and Blue Shield Plans*
Health Plan Week
Health Plan Facts, Trends and Data
The Next Generation of Disease Management

*The AIS Guide to Blue Cross and Blue Shield Plans and The AIS Report on Blue Cross and Blue Shield Plans are published independently by AIS. They are not affiliated with or sponsored, endorsed or approved by the BlueCross and BlueShield Association or any of the independent Blue Cross and Blue Shield companies.

For further information call 800-521-4323 or e-mail customerserv@aishealth.com