Health Plan Facts, Trends and Data: 2014-2015

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Publication Details

  • Pub Code: GHPF19-11WEB
  • Pages: 348
  • ISBN: 978-1-936230-79-2
  • Copyright 2014

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Health Plan Facts, Trends and Data: 2014-2015

A best-selling annual book packed with insights into important trends that are re-shaping the health care industry. This one-of-a-kind resource contains reliable data, directories and other valuable resources you can put to work today. Written and organized by AIS's experienced health reporting staff.

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Get the perspective you need to make sense of the state of the health plan industry with Health Plan Facts, Trends and Data

Health Plan Facts, Trends and Data is a comprehensive one-of-a-kind resource on the U.S. health insurance industry. It provides valuable intelligence on a wide range of big-dollar health plan issues — from benefit design and management strategies to corporate financial results and enrollment — that can be of great assistance to you and your management team in the year ahead.

This unique, well-organized resource helps you quickly get up-to-speed on:

  • Industry-wide Trends — such as enrollment and market share trends including MA and Medicaid enrollment at the county level, rate-setting practices, and joint ventures between health plans and providers
  • Strategies and Markets — with in-depth looks at participation and competitive strategies in public and private exchanges, ACO launches and expansions, and expansions into the managed Medicaid and youth markets
  • Regulatory Impact — analyses of the effect of fees, out-of-pocket limits, third party payments and the employer mandate on insurers and employers
  • Business News — with synopses of M&A activity, financial and stock market performance, personnel decisions and executive compensation trends

Order your copy of Health Plan Facts, Trends and Data: 2014-2015 today!

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

  • Enrollment Data
  • Medicare Advantage Enrollment Data
  • Medicare Advantage County Enrollment Highlights
  • Managed Medicaid Enrollment Data
  • Medicaid County Enrollment Highlights

Chapter 2: Health Plan Organizational Structure and Leadership

  • Executive Compensation Trends
  • Lobbying, Donations and Political Advertising
  • Staffing and Leadership Decisions

Chapter 3: Health Plan Financial Performance

  • Costs and Profitability
    • MA Payment Rates
  • Second Quarter 2013 Results
  • Third Quarter 2013 Results
  • Fourth Quarter 2013 Results
  • First Quarter 2014 Results
  • Stock Market Performance
  • Key Financial Data

Chapter 4: Market Moves and Expansions

  • Mergers, Acquisitions and Divestitures
    • Alliances
  • Market Expansion Strategies and Developments

Chapter 5: Managed Medicaid Expansion Initiatives

  • Medicaid Enrollment Growth
  • Contract Developments
    • ACA Carrier Fee Negotiation
  • Dual Eligibles
  • States’ Expansion Initiatives

Chapter 6: Health Plan Benefit Design and Consumer Markets

  • Benefit Design and Offerings
    • Coverage for Young Adults
    • Consumer-Directed Health Plans
  • Narrow Networks
  • Rates and Premiums
  • Retail Insurance Outlets
  • Ancillary Products
  • Medicare Advantage Products
    • Marketing of MA Star Ratings

Chapter 7: Private Exchanges

  • Competition and Expansion
  • Strategies for Tapping Into Employer Demand
  • Single-Carrier Exchanges
  • ACO and Other Provider-based Models

Chapter 8: Insurer Participation and Strategies for Public Exchanges

  • Enrollment Projections and Results
  • Health Plans’ Exchange Strategies
    • Multi-State Plans
  • Participation and Competition
  • Impact on Brokers
  • Premium Rates on Exchanges
    • 2014 Premiums
    • 2015 Premiums
  • SHOP Exchange
  • Metal Tiers

Chapter 9: New Regulations’ Impact on Insurers and Employers

  • Regulations Affecting Insurers
    • Insurer Fees
    • Out-of-Pocket Limits
    • Non-ACA-compliant Plans
  • Regulations Affecting Employers
    • Employer Mandate
    • Cadillac Tax
  • Mental Health Parity
  • Third-Party Payments

Chapter 10: Provider/Health Plan Transactions and Developments

  • Network Administration and Reimbursement Strategies
  • Health System Forays Into Insurance Products
    • Affiliations and Joint Ventures Between Health Plans and Providers
  • ICD-10 Compliance
  • Network Terminations

Chapter 11: Accountable Care Organizations and Other Quality Arrangements

  • Health Plan Strategies for ACOs
  • Public-Sector ACOs
  • Product Launches and Expansions
  • Bundled Payment and Other Value-Based Programs
  • Measuring Quality

Chapter 12: Health Promotion, Wellness and Disease Management Strategies

  • Disease Management for Chronic Conditions
  • Strategies for Specific Health Conditions
    • Asthma
    • Diabetes
    • Sleep Disorders
  • Palliative and End-of-Life Care
  • Wellness Initiatives

Chapter 13: Health Plan Strategies for Pharmacy Benefit Management

  • PBM Contracting Decisions
  • Curbing Drug Costs
    • Sovaldi
  • Medicare Part D Products
  • MTM, Member Adherence and Drug Safety
  • Copay Coupons
  • Coverage of Contraceptives
  • Genetic Testing
  • Oncology Pathways

Chapter 14: IT Strategies, Challenges and Opportunities

  • Customer Outreach Tools and Strategies
  • Health Insurer Investment in IT
  • Quality and Cost Data Transparency Tools
  • Data Security
  • Telemedicine

Chapter 15: Health Plan Resources and 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
  • Directory of State Insurance Commissioners
  • Directory of State Medicaid Directors
  • State Medicaid Pharmacy Directors

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 the value of this highly practical resource. If within 30 days you're not interested in keeping it, just return it to AIS and we will send you a prompt, full refund or credit. 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.

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Health Plan Facts, Trends and Data: 2014-2015

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