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

The AIS Guide to Blue Cross and Blue Shield Plans: 2010 is published independently by Atlantic Information Services. It is not affiliated with or sponsored, endorsed or approved by the Blue Cross & Blue Shield Association or any of the independent Blue Cross & Blue Shield companies.

The completely updated competitive intelligence resource, The AIS Guide to Blue Cross and Blue Shield Plans, contains reliable information on Blues products, market strategies, acquisitions & alliances. It includes financial projections & hard-to-find data on executive compensation, revenues, earnings, enrollment & medical loss ratios, plus insight into premium trends, rate hike proposals, & more.

You can use this information to gain an understanding of Blues plans market strategies, operational tactics & cost-containment techniques. This unique resource is the only place you can find reliable data on Blues history, function & structure, along with BCBS plan executive compensation stats & exclusive interviews with CEOs on plan strategies, philosophies & opportunities.

Table of Contents
Ch. 1: What Is a Blue Cross and Blue Shield Plan?
* History, Function & Structure of the BCBSA
* BCBSA Financial Results
* BCBS Trade Names & Marketing Advantages
* BCBSA Licensee Requirements & Association Guidelines
Ch. 2: Corporate Leadership, Structure & Events
* Corporate Growth Strategies
* Mergers, Acquisitions & Divestitures
* BCBS Plan Leadership & Staff Changes
* Green Initiatives
Ch. 3: Enrollment Statistics & Market Share
* Membership Gains & Losses
* National Enrollment & Market Share
* Enrollment Breakdown by Sector & Risk
* Enrollment & Market Share by State
Ch. 4: Financial Performance of BCBS Companies
* Publicly Traded Financial Results
* Not-for-Profit Financial Results
* Cost Containment Strategies & Medical Cost Ratios
* Administrative Spending
* Reserve Levels
* Medical Fraud Recovery
* Cost & Revenue Data
Ch. 5: Growth Strategies for Specific Companies & Markets
* Targeting Uninsured With Public/Private Partnerships
* Individual (Non-Group) Products
* Group Health Offerings & Contracts
* Local Market Issues & Strategies
* Medicare Advantage & Medicare Part D
* Medicaid, SCHIP & Local Public Programs
* TRICARE
Ch. 6: Benefit Design & Coverage Issues
* Coverage Policies & Rescissions
* Pharmacy Benefit Strategies & Results
* Mental Health Parity & Autism
Ch. 7: Premiums & Rate-Setting Issues
* Premium Trends
* Rate Hike Proposals, Awards & Denials
Ch. 8: Health Care Reform & Lobbying
* Health Reform Provisions
* Health Reform Negotiations, Testimony & Lobbying Efforts
* Political Donations & Lobbying Expenses
* State-Level & Local Health Reform Initiatives
Ch. 9: Provider Relations, Fees & Conflicts
* Alternative Quality Contracts & Global Payment Systems
* Fee Schedules & Reimbursement
* Never-Event Policies
* Provider Incentives & Quality Data
Ch. 10: Other Legal & Regulatory Challenges
* Anti-Competitiveness, Near-Monopolies & RICO
* Tax-Exempt Status & For-Profit Conversions
* Fraud & Abuse, Corruption & Wrongdoing
Ch. 11: Wellness, Prevention & Disease Management Programs
* Health Improvement Initiatives
* Behavioral Health Management
* Oncology Management
* Medical Home Models
Ch. 12: Information Technology & Claims-Processing Issues
* Operational Software & Systems
* ICD-10 Implementation
* Security Breaches and Issues
* Online Physician Visits
* e-Prescribing Initiatives
Chapter 13: Directory of Blue Cross and Blue Shield Organizations