Health Plan Facts, Trends and Data: 2015-2016

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Publication Details

  • Pub Code: GHPF20-11WEB
  • Pages: 348
  • ISBN: 978-1-939721-06-8
  • Copyright 2015

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Health Plan Facts, Trends and Data: 2015-2016

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. Our in-house editorial and research teams have closely tracked enrollment and market trends over the past year — including MA and Medicaid enrollment, premium rates and integrated health systems.
  • Insurer Strategies. You’ll read in-depth accounts of health plans’ competitive strategies in public and private exchanges, new reimbursement strategies such as value-based care and bundled payments, and pharmacy benefit cost containment strategies — especially as new hepatitis C treatments and biosimilars come to market.
  • Market Impact. Insurers are making inroads into the individual market, by adapting products and marketing strategies as the industry becomes more consumer-driven.
  • Industry Innovations. Recently, the industry has seen a slew of innovative new tactics — new market entrants from nontraditional health care companies, venture capital investments from insurers, a growing use of population health data in providing patient care … and more.
  • Business News. Synopses of mergers, acquisitions and divestitures, financial and stock market performance, personnel decisions and executive compensation trends.

Order your copy of Health Plan Facts, Trends and Data: 2015-2016 today, and have key health plan business trends at your fingertips!

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 and Market Share

  • Enrollment Data
  • Medicare Advantage Enrollment Data
  • Medicaid Enrollment Data
  • Dual-Eligibles Data

Chapter 2: Health Plan Organizational Structure and Leadership

  • Executive Compensation Trends
  • Workforce Developments
  • Leadership Decisions and Appointments

Chapter 3: Health Plan Financial Performance

  • Costs and Profitability
  • Medical Loss Ratios
  • Second-Quarter 2014 Results
  • Third-Quarter 2014 Results
  • Fourth-Quarter 2015 Results
  • First-Quarter 2015 Results
  • Stock Market Performance
  • Key Financial Data

Chapter 4: Market Moves and Expansions

  • Mergers, Acquisitions and Divestitures
    • Health Plan Acquisitions and Sales of Non-health plans
  • Market Moves and Developments
  • Medicaid Market Developments

Chapter 5: Health Plan Product Offerings, Marketing and Benefit Design

  • Outreach Efforts
  • Benefit Design and Offerings
    • ACOs
    • High-Deductible Health Plans
    • Health Savings Accounts
  • Commercial Markets
    • Small Group
    • Individual
    • Large Group
  • Network Design
    • Narrow Networks
    • Tiered Networks
  • Medicare Advantage Products
    • Marketing of MA Star Ratings

Chapter 6: New Market Players and Insurance Alternatives

  • Broker Platforms and New Distribution Channels
  • Health Care Sharing Ministries
  • Boeing Direct-to-Employer ACO
  • Retail Market Expansions
  • Overseas Efforts
  • Vivity and Other Joint Ventures
  • Investment Opportunities

Chapter 7: Private Exchanges

  • Private Exchange Growth Trends
    • Launches and Expansions
  • Insurer Strategies for Private Exchanges
  • Employer Adoption of Private Exchanges
  • Decision-Support Tools

Chapter 8: Insurer Participation and Strategies for Public Exchanges

  • Participation and Competition
    • Consumer Owned and Operated Plans
  • Federal Oversight and Guidance
    • Risk Corridors
  • Exchange Premium Rate Trends
  • Exchange Premium Rate Data

Chapter 9: Provider/Health Plan Transactions and Developments

  • Network Administration and Reimbursement Strategies
  • Integrated Health Systems and Payer Collaborations
  • Bundled Payments

Chapter 10: Accountable Care Organizations and Other Value-Based Care Arrangements

  • Commercial ACO Strategies and Trends
    • Medicare Advantage ACOs
  • Health Plan ACO Arrangements and Collaborative Agreements
  • ACO Results
  • Public-Sector ACOs
  • Patient-Centered Medical Homes
  • Payer Strategies for Value-Based Care

Chapter 11: Health Promotion, Wellness and Disease Management Strategies

  • Wellness Initiatives
  • Chronic Disease Management
  • Palliative and End-of-Life Care
  • Strategies for Specific Health Issues

Chapter 12: Health Plan Strategies for Pharmacy Benefit Management

  • Formulary Strategies
  • Copay Capping
  • Use of Generics
  • Coverage of Contraceptives
  • Genetic Testing
  • Compounded Drug Costs
  • Specialty Drug Strategies
    • Hepatitis C Drugs
    • Biosimilars
  • Prescription Drug Benefit Design Data

Chapter 13: IT Strategies, Challenges and Opportunities

  • Population Health Data
  • Apps and Mobile Technology
  • Telemedicine
  • Data Security and Insurer Breaches

Chapter 14: Health Plan Resources and Directories

  • Directory of State-Based Exchanges
  • Directory of Federal and Regional Medicare Regulators
  • Directory of Health Plan Trade Associations
  • Directory of State Health Plan Associations
  • State Insurance Commissioners
  • State Medicaid Directors
  • State Medicaid Pharmacy Directors
  • 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 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: 2015-2016

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