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Managed Care Industry Resources
  The Executive Report on Managed Care

Providing twice-monthly news and information on issues affecting managed care plans, managed care legislation and regulations, as well as real-life examples of successful MCO programs, services, and cost-saving initiatives.


  The Executive Report on Physician Organizations

This newsletter provides monthly news and information on issues concerning quality health care, strengthening contractual relationships, improving administrative efficiencies and customer service.


  Pay for Performance Reporter

The Pay for Performance Reporter will provide you with answers to questions you may have, with facts, news, insight and emerging P4P developments. Discover how early adopters achieved physician "buy in," the importance of leverage, how to choose your measures wisely and choose measures that are defensible, and why provider feedback is so important.


NEW! Audio Webcast Scheduled for Wednesday, October 1, 2008 from 1:30-3:00 PM Eastern Time

Emerging Trends in the Globalization of Healthcare: Can Medical Tourism Really Be An Alternative for Health Plans, Employers and Patients?

Global healthcare, also known as medical tourism, is an emerging industry that is no longer just a self-pay and cosmetic surgery phenomenon. Increasingly, patients are traveling for “serious” surgeries, including major non-cosmetic elective procedures such as joint replacement, heart valve replacement or back repair, with cost savings ranging as high as 60 to 90 percent. Join the Managed Care Information Center to hear insider insight into the opportunities as well as risks that are involved with the globalization of healthcare in this 90 minute audio webcast.


NEW!  Now Available on CD-ROM

Never Events: Reducing Preventable Errors and Their Impact

CMS launched its Hospital-Acquired Conditions (HAC) initiative in October 2007. This coming October, Medicare will expand the current list of eight HAC to 17 preventable errors that they will no longer pay for. Join the Managed Care Information Center and three industry leaders in this 90 minute audio conference and webinar.


Disease Management Critical Outcomes Report Analysis (CORA) Certification Training and Certification Examination

Disease management reporting is a skill which few have mastered. In fact, roughly 70% of disease management outcomes reports contain fundamental errors invalidating their results... right in the report itself. If you are a writer of these reports it is critical to spot these errors before the customer does. If you are a reader of these reports, it is imperative for you to spot these errors before you accept the findings. Join The Managed Care Information Center and Al Lewis from the Disease Management Purchasing Consortium for this audio conference, certification training and optional certification examination.

NEW! Now Available on CD-ROM

Health Plan Transparency Strategies and Initiatives: Investing in Today's Market and Business Mandates

Value considerations, including price and quality, are beginning to transform how consumers make healthcare decisions. As a result, health plans need to provide information that is useful to consumers, instead of just publishing technical data, experts say. Learn how leading US healthcare payers are approaching transparency and what future opportunities transparency will lead to in the future. Join The Managed Care Information Center in this 90 minutes audio conference and webinar.

NEW! Now Available on CD-ROM

Healthcare Data Pooling and Evidence-Based Measures: Understanding The Coming Changes in Employer, Payor and Provider Dynamics

A key topic in the upcoming US presidential election is the issue of providing high-quality healthcare and simultaneously controlling costs. Data pooling can help fuel quality and efficiency measures and provide real knowledge about local trends. Join the Managed Care Information Center and Milliman to learn about the best practices and lessons learned in current data pooling initiatives and its future potential in in this 90 minute audio conference and webinar.

NEW! Now Available on CD-ROM

What’s Ahead for Healthcare Reimbursement: Are You Ready for the New Payment Models and Initiatives?

There is widespread agreement that the current healthcare fee-for-service payment system needs to be to be revamped. Today, more than ever, a significant amount of attention is being spent on finding ways to improve health care quality and health outcomes while controlling health care cost growth. Learn new strategies for payment restructuring most effectively address the current fee-for-service problems in this 90-minute session.

NEW! Now Available on CD-ROM

Keeping Score: A Comparison of Pay-for-Performance Programs Among Commercial Insurers

Pay-for-performance (P4P) represents a radical departure from traditional payment methods. P4P has been gaining traction, largely because the Centers for Medicare and Medicaid Services (CMS) has told hospitals and physicians that future increases in payment will be linked to improvements in clinical performance. Join The Managed Care Information Center and PricewaterhouseCoopers’ Health Research Institute in this 60-minute audio conference and webinar.

NEW! Now Available on CD-ROM

Successful Clinical Integration Initiatives in Physician Organizations: How to Build a FTC Compliant Program

During the past five years there has been a significant increase in enforcement activity by the FTC in response to complaints alleging that physician networks are engaging in the suppression of price competition and utilizing structures that fail to meet FTC guidelines. Join the Managed Care Information Center for this 90-minute audio conference and webinar.

NEW! Now Available on CD-ROM

Forecast: What's Ahead for Managed Care in 2008

The managed care market faces a series of challenges and opportunities in 2008 that may change the face of the industry and therefore impact both health providers and payors. Join The Executive Report on Managed Care and the Managed Care Information Center in this 90-minute audio conference and webinar.

NEW! Now Available on CD-ROM

Payor-Provider Managed Care Contract Negotiations: Current Strategies and Best Practices to Maximize Reimbursement

Managed care contracts are one of the most important drivers of a healthcare organization’s financial reimbursement, cash flow and profitability. Developing strategic contracting language can dramatically improve your revenue stream. But failing to clarify certain payment terms could also lead to long-term financial problems. Join The Managed Care Information Center and three experts in managed care negotiations in this 90-minute audio conference and webinar.

NEW! Now Available on CD-ROM

Mergers and Acquisitions in the Managed Care Industry: The Trends, Issues and Outlook for 2008

The recent credit debacles caused by the subprime mortgage mess and over-leveraged private equity transactions will certainly be remembered as we look back on 2007. The current wild gyrations in the financial market have jeopardized several large mergers and acquisitions deals and severely depressed the stock of a number of leveraged buyout firms. Join The Managed Care Information Center to discover what the future may hold for health plan M&A’s in the months and year ahead in this 90-minute audio conference and webinar.

What's Ahead for Disease Management: The Evolution From Chronic Disease Management Toward Integrated Care and Health Management

The disease management industry is in transition today as it evolves to include interventions across the care continuum. Stand-alone programs focused on a single disease are transitioning to integrated care programs that include health and wellness promotion, disease management, and care coordination. Join The Managed Care Information Center and three of the nation’s top disease management experts for in this 90-minute audio conference and webinar.

NEW! Now Available on CD-ROM

Lean/Six Sigma Approaches in Healthcare: How to Improve Quality and Substantially Increase Profitability

“Six Sigma” and “Lean” are both buzzwords in healthcare today. These highly effective improvement approaches have been successfully implemented across many industries. Today, the application of Lean and Six Sigma techniques at healthcare organizations are achieving astonishing results. Join The Managed Care Information Center to hear how healthcare organizations participating in Lean / Six Sigma programs can experience significantly higher incomes through increased revenues and the lowering of operating costs in this 90-minute audio conference and webinar.


NEW! Now Available on CD-ROM

Developing Collaborations to Drive ePrescribing: Best Practices, Case Studies and Key Factors for Success

Health plans are joining forces with competitors, technology vendors, pharmacies and other organizations in a collaborative effort toward the successful adoption of ePrescribing in order to improve patient safety, healthcare affordability, quality and delivery. Join The Managed Care Information Center to learn how leading collaborations are driving ePrescribing in this 90-minute audio conference and webinar.

NEW! Now Available on CD-ROM

Retail Clinics: Opportunity or Threat for Today’s Healthcare System

The explosion in retail health clinics is changing the healthcare system as we know it. It is having an effect on all areas of the industry – and getting the attention of both health plans and providers. Looking for an easy way to get up to speed on the opportunities available in this new outlet? Join The Managed Care Information Center and three experts on this industry trend for this special 90-minute audio conference on CD-Rom.

NEW! Now Available on CD-ROM

Healthcare Reform:  Will It Really Happen This Time?

The national healthcare crisis is growing in severity. Costs are spiraling out of control. Forty-seven million Americans are without health insurance and there is a general lack of access to quality care. Americans are concerned.   With a change in the way healthcare is delivered rapidly approaching, join The Managed Care Information Center for an assessment of current legislative forces and how they are shaping the future of the health and managed care industry in this executive level audio conference on CD-Rom.

NEW! Now Available on CD-ROM

Consumer-Driven Healthcare: Key Drivers and Future Market Adoption

Consumer-driven health plans (CDHPs) continue to be considered the solution to reducing healthcare costs and the roles of the uninsured in the nation. Join the Managed Care Information Center and experts of consumer-driven healthcare for a discussion of the current trends and future expectations in this 90-minute audio conference on CD-Rom.

Disease Management ROI: Benchmarks, Metrics, and 
Case Studies for Success

There is an ongoing controversy surrounding return-on-investment (ROI) of disease management programs is calculated. What are the true cost savings of specific disease management programs? And what is the best way to calculate the ROI of your DM programs? Join the Managed Care Information Center and experts on disease management analysis for a discussion about disease management and ROI in this 90-minute audio conference on CD-Rom.

Pay-for-Performance: Lessons Learned and Future Predictions 

Are physician incentives the panacea to a struggling healthcare system leading to strengthening quality measures, improved outcomes, and increased patient and health plan member satisfaction? Join Pay-for- Performance Reporter and the Managed Care Information Center along with the pioneers of pay-for-performance for a discussion of past successes and the challenges ahead in this 90-minute audio conference on CD Rom.

Forecast: What's Ahead For Managed Care in 2007

The managed care industry faces a series of challenges in 2007 that may change how business is conducted for both health providers and payors. Pressures to lower healthcare costs and increase the quality of care, along with the growing army of uninsured, will all have an effect on managed care plans. Join The Managed Care Information Center for a review of the challenges ahead in the 90-minute audio conference on CD-Rom.

The National Directory of Managed Care Organizations, Sixth Edition

The National Directory of Managed Care Organizations profiles more than 5,300 organizations. Available in Print, Database on CD ROM, Directory on CD ROM and Online formats. Also available on CD ROM by state.


Consumer-Driven Healthcare: The Growth, Strategies, and Mixed Opinions

This 40-page report contains the leading success factors in consumer- driven healthcare, concrete results of CDHPs so far, detailed survey results and briefings by leading consultants and agencies.


Pay-for-Performance:  Incentives, Models, Measures and Perspectives

As quality concerns escalate and healthcare costs skyrocket, P4P incentive programs are being implemented by health plans around the country as a way to reward healthcare efficiency and effectiveness.  This report gives you a comprehensive understanding of this developing reimbursement trend that may change how providers are measured and paid and improve the quality of care and patient satisfaction. 


The Managed Care Business Information Library CD ROM

Use your Desktop PC to browse this exclusive compilation of vital managed care facts, statistics, costs, premiums, analyses, comparisons, managed care market news, enrollment data, cost comparisons between HMOs and PPOs, hospital utilization trends or costs per employee by plan type.


Managed Care Market Datasource

For the first time anywhere, now you can get on one easy to use CD-ROM, an managed care industry market research archive of the most important developments that have occurred during the past two years, details on the mega mergers and acquisitions, the key MCO trends, statistics, results of research, industry studies, and surveys. Find what you’re after in seconds.


The National Directory of Physician Organizations, Third Edition

The National Directory of Physician Organizations profiles more than 2,773 organizations. Available in Database on CD ROM and Directory on CD ROM, PDF Format.


NEW !

The National Directory of
Workers' Compensation Managed Care

The National Directory of Workers' Compensation Managed Care provides comprehensive profiles and key business information and executive contacts on 264 health plans that offer workers' compensation insurance managed care products. Available in Print and PDF format.


Mergers and Acquisitions in the Managed Care Industry: The Trends, Issues and Impact

During the first three quarters of 2005, $111.8 billion was committed to healthcare mergers and acquisitions. In the third quarter, $57.5 billion was committed to finance healthcare deals. And the managed care sector alone posted three billion dollar deals in the third quarter totaling $16.9 billion.

Join speakers from three leading investment banking companies that focus on merger & acquisition services in the healthcare industry for both providers and payors to learn the current trends in M&A's, what are the issues, what are state officials' issues, what acquirers are seeking in a suitable fit, the strategic buyer's interests, and, finally, the impact on providers in a consolidated market.


The National Directory of Integrated Healthcare Delivery Systems, Third Edition

The National Directory of Integrated Healthcare Delivery Systems profiles more than 830 organizations. Available in print, PDF on CD-Rom and database version.


What's Working in P4P 'Box Set'

Looking for an easy way to acquaint your team with “pay-for-performance” (P4P)? Introducing the P4P Audio Conference CD Box Set. These highly rated, executive-level telebriefings on CD are ideal for low cost, affordable team training.

The programs feature four early adopter insiders providing details, metrics, payment structure, characteristics of successful programs, design principles and what's working are key points covered in three hours of high-level management discussion on details on pay for performance.


Winning Ideas in Health Plan Wellness and Health Improvement Programs: What's Working Today to Achieve Member Commitment and Participation Free personalized online lifestyle-improvement programs, rewards for health plan members who use health management and disease management programs, online health risk assessment and reimbursement for health club membership dues, are among the wellness initiatives that health plans are offering their employees and members.

The growth and market adoption of consumer-driven health plans will continue to drive health plans to develop more widespread member health improvement initiatives. In fact, some plans are developing innovative approaches. Discover what?s working in health plan wellness and health promotion programs, award winning and unique programs, best practices, ROI, and lessons learned in this special audio conference.


Expedite: The Information Toolkit for Sellers of Products and Services to Managed Care

The Expedite: Managed Care Information Service is an online service designed to meet the needs of major account - national account, marketing and sales managers.


Can We Get To Yes? Key Issues in Managed Care Payor-Provider Contracting

Increasingly hospitals are walking away from payor contracts. Physicians are not only dropping out of health plan networks, but also some are not accepting health insurance. And the headlines carry more and more news about physicians-payor lawsuits.

How do you get to "yes" in this environment? Can payors and providers find room to reach agreement? Are providers willing to leave money on the table?

The goal of this conference call is to provide a 360-degree assessment of health plan - provider contracting issues for the coming round of negotiations. MCO consolidation in many key markets may tip the scales. Can hospitals negotiate adequate reimbursement when up against the proverbial "900 pound gorilla?"


Getting It Right: Designing Outcomes-Based Physician Incentive Compensation

Over the past 3 years, millions of dollars have been awarded to physicians as quality improvement incentives. Health plans are "rushing" to develop performance-related physician incentive programs.


Innovative Managed Care Plan Strategies

Health plans have launched a variety of innovative initiatives to balance the cost-quality equation and streamline the referral and pre-authorization processes. Learn how these major health plans have developed approaches that help employers and their employees manage costs while still maintaining access to quality healthcare.


The National Directory of
Medical Directors on CD-ROM

More than 1600 physicians have been identified in this new and unique database resource.


Managed Care Formulary and Pharmaceutical Benefit Management Under E-Prescribing

E-prescribing makes formularies automatically and electronically accessible, and therefore considerably more enforceable, at the point of prescription," says Dr. Martin B. Silverstein, co-author of the BCG report “Vital Signs: e-Health in the United States.” Plus, guidelines have recently been adopted by the American Medical Association (AMA) House of Delegates to help physicians safely and securely prescribe medications to patients over the Internet


Health Savings Accounts 2005: Market Adoption, Acceptance, Growth and Regulatory Refinements

For the past year, health insurors have been developing and launching health savings accounts, their newest product offering. Health savings account (HSAs) are part of the Medicare Prescription Drug, Improvement and Modernization Act of 2003. HSAs are designed to help individuals save for future qualified medical and retiree health expenses on a tax-free basis


New Directions in Disease Management: Medicare- Medicaid, Strategies, Outcomes, ROI

Disease management (DM) is now in the forefront of efforts to improve overall member health status and have an impact on health costs. Early DM programs focused primarily on such illnesses as diabetes, congestive heart failure, asthma and chronic obstructive pulmonary disease. But over the past few years, some DM providers have branched out into offering DM programs for rare and sometimes even fatal conditions such as cancer, Parkinson's disease, lupus, ALS and sickle cell anemia.


Next Generation - MCO Web Site Strategies

CD-ROM

From communicating online with members, providers, and employees to claims processing, enrollment, case management and disease management, managed care organizations (MCOs) continue to shift many member and provider services to the Internet.

Hard Copy

This convenient hard copy report takes the above MCO web site strategies audio conference and provides it to you in a readable format, including the complete text of speakers' presentations and conference "handout" material.


New Strategies in The Growth of Consumer Driven Healthcare

CD-ROM

Pushed by the federal government's embrace of consumer decision-making along with soaring costs of healthcare, employers and health plans are adopting consumer driven health plans.

Hard Copy

This convenient hard copy report takes the transcript of the above consumer-driven audio conference and provides it to you in a readable format, including the complete text of speakers' presentations and conference "handout" material.


Defining the Value of Disease Management: How Health Plans Are Aiming For Improved Outcomes, Healthier Members And Cost Savings

This special report includes information on DM program fundamentals, such as establishing a program management team, patient registry, treatment guidelines, patient education, patient monitoring, treatment interventions, outcomes measurement, program reports and screening programs.


New Cost Savings Promise: Emerging Trends Fueling the Growth of Consumer-Driven Health Plans

A special report from the Managed Care Information Center that gives you an assessment of what the future may hold—the challenges, advantages and disadvantages.


The Managed Care Yearbook, Fifth Edition

The 22 chapters in the new The Managed Care Yearbook, contain more than 608 pages of industry business information and competitive intelligence: managed care issues, costs, analyses, comparisons, insight, strategies and benchmarks.


Healthcare Industry Market Yearbook, Second Edition

Now in a practical desk reference, you can have at your fingertips an "almanac" of the rapidly changing healthcare environment. You'll use Healthcare Industry Market Yearbook often for market research, business development activities, to track players in the managed care field, to track competitors, the chart trends, and to review key industry surveys and studies.


The Healthcare IS/IT Market Yearbook

A unique and valuable sales and marketing reference tool for IT companies selling into the healthcare and managed care industries.


Physician Compensation: Emerging Trends and Strategies

In this new era of healthcare, both hospitals and MCOs acknowledge that the physician holds the key to each other's future success. That's why much thought and care must be given to the development of physician compensation plans. From fee-for-service to issues in capitation, dealing with physician compensation affects more than your bottom line, but also patient relations, member retention and the long-term financial viability of your organization.


Integrated Healthcare Delivery System Yearbook

The yearbook provides details of the trends in integrated care and capitation, with strategic tips for getting ahead in this environment. You'll learn not only about the financial issues involved in IDS formation, but the antitrust hurdles you'll need to overcome


Managed Care Leadership: Marketing Your Health Plan To Growth and Member Satisfaction

Health Risk Assessments: From Participation to Payoffs in Risk Reduction and Health Outcomes

New!
Health Risk Stratification: Targeted Tools and Methodologies to Prevent Illness and Improve Health

New!
Toward Transparency in Healthcare: Competing for Quality and Consumers

New!
Reaching Reluctant Physicians: Forging Organizational Trust and Collaboration

New!
For Emergency Use Only: Curbing Unnecessary Emergency Room Use through Education, Accountability and Physician Engagement

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© 2007 Health Resources Publishing