Featured Special Reports

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Case Studies From Private-Sector ACOs: What Works and Why?
Insights from state Medicaid programs, payers, providers, consultants and other stakeholders who are navigating the many business decisions that must…
CMS’s Part D Audit Findings: A Roadmap for Plan Sponsors
A collection of summaries of CMS’s recent audit reports that will help Part D plans avoid becoming agency targets. It…
CMS Star Quality Ratings: Shifting Strategies for Medicare Advantage and...
An in-depth look at the impact and implications of CMS’s star-ratings system so far, as well as how the star-rating…
Health Insurance Exchanges: Preparing for the Brave New Marketplace Ahead
Timely insights from industry consultants, state lawmakers and regulators, scholars and other key industry observers on how state health insurance…
Health Insurance Plan-Design Trends for Group and Individual Markets
Contains valuable insight and examples from health insurers, brokers and agents, employers and other industry observers on how the changing…
Health Plan Strategies for the Individual Market
Contains valuable insight on the benefit design innovations, marketing tactics and legal challenges being faced by health plans in the…
Health Reform 2011: Impact on Health Plans, Hospitals, Providers and...
Outlines the likely impact of health reform on coverage, benefit designs, medical costs, providers and pharmacy benefits. In this 150-page…
Improving Adherence and Containing Rx Costs: New Health Plan/PBM Strategies
Examines the pharmacy benefit management strategies that health plans, PBMs and payers have found most successful at reducing costs, improving…
Incorporating Personalized Medicine Into Health Plan Management Strategies
Filled with articles on how health plans and PBMs are using personalized medicine to improve members’ health outcomes and control…
Managing Specialty Drugs Across the Medical and Pharmacy Benefits
A practical report filled with strategies health plans are employing to effectively manage specialty drugs under the medical benefit using…
Medicaid Compliance Strategies for Hospitals and Other Providers
Filled with articles that will help Medicaid providers understand what to expect when state or federal auditors come calling, and…
Medicare Part D: A Comprehensive Analysis of CMS Rules
Distills from thousands of pages of CMS regulations and guidance the major rules, guidelines and deadlines you need to comprehend…
Medicare Plan Marketing in the Regulatory Crosshairs: New Enforcement...
Provides information on meeting current — and future — rules from CMS and the HHS Office of Inspector General on…
Next-Generation Insurance Benefit Design and Marketing
A report filled with details of how health insurers are refining benefit designs to respond to employer demands and comply…
RACs: Proven Tips and Tactics to Reduce Your Audit Risks and Appeal...
A comprehensive report that offers guidelines on areas ripe for review and strategies on how to effectively appeal recovery audit…
Special Needs Plans: Regulatory Challenges and Market Strategies
Answers questions about major developments in Medicare Advantage Special Needs Plans (SNPs) during the past few years, from both a…
Vendor Gifts and Relations: Effective Strategies for Health Systems and...
A report that shows you how to identify and manage potential gift conflicts, avoid possible compliance minefields and make sure…

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