Managed Medicare & Medicaid Factbook: 2011

Managed Medicare and Medicaid Factbook: 2011 provides convenient access to up-to-date enrollment data so you can easily evaluate market share, make plan-by-plan or state-by-state comparisons, identify opportunities and develop strategies. It includes current statistics on:
*MA, Medicare managed care, Medicare Part D and managed Medicaid enrollment
*Medicare eligibles by state, market penetration by state and by region
*Enrollees by type of product including Part D, Special Needs Plans, HMO, local PPO, regional PPO, PFFS and others
*Directories of MA, Medicaid plans and Part D plans with contact information
*MA and Medicaid plans financial trends

The completely updated Managed Medicare and Medicaid Factbook: 2011 also includes new coverage of these hot topics:
*Costs, premiums, rate cuts and profitability;
*Star ratings, quality bonuses and ACO alliances;
*State initiatives in Medicaid; and
*Marketing regulations and bid strategies, along with other challenges such as meaningful differences, rate cuts, RADV audits, RACs and data reporting requirements.

You can have all of this information at your fingertips no need to contact 50 different Medicaid agencies, scour through the convoluted CMS website, or cut and paste to get data into a format that lets you compare apples to apples. Our experts have compiled the most relevant and timely facts for you and presented them in a way that provides one, easy-to-access resource of the managed Medicare and Medicaid data you need to develop sound strategies for 2012 and beyond.

Table of Contents
Ch 1: MA Market Developments
*MA Market Expansions
*Mergers and Acquisitions
*Private-Fee-for-Service Plans
*Special Needs Plans
*Alliances With ACOs
Ch 2: Strategies and Challenges for Marketing MA and Part D Plans
*2011 Enrollment Season
*Regulation and Enforcement of Marketing Rules
*Product Development and Benefit Design
*Marketing Alliances
Ch 3: Bid Submissions, Evaluations and Denials
*Meaningful Differences Among Products
*Bid Strategies, Challenges and Results
*Bid Denials and Violations
Ch 4: Medicare and Medicaid Plans Financial Performance
*MA Financial Trends
*MA Financial Results
*Medicaid Plans Financial Results
*Stock Performance
*Leadership Changes at Medicare and Medicaid Plans
Ch 5: Costs and Premiums for MA and Part D
*Payment Rate Cuts
*Rising Premiums
*Cost Savings
Ch 6: MA Plan Audits
*Data Validation
*RADV
Ch 7: New MA Data Reporting Requirements
*Regulatory Burdens
*RACs
*Encounter Data Reporting
Ch 8: MA Star Ratings and Other Quality Initiatives
*Criteria and Measures for Quality Ratings
*Quality Bonuses
*Flagging Poor Performers
*NCQA Rankings
Ch 9: Medicare Managed Care Enrollment Trends and Market Share Data
Ch 10: Medicare Part D Prescription Drug Data
*Enrollment Data
*Federal Retiree Drug Subsidy
*Low-Income Subsidy
*Directory of PDPs Sorted by Parent Organization
Ch 11: Regional Managed Medicare Marketplace Data
Ch 12: MA Plan Directory
*MA, Cost, PACE and Demonstration Plans
Ch 13: Dir. of Federal and Regional Medicare Regulators
Ch 14: Managed Medicaid Business Strategies and Developments
*Medicaid Plans Expansion
*Contract Decisions
*Mergers and Acquisitions
*Payment Rate Changes
*Legal Conflicts
Ch 15: Managed Medicaid Developments in States
*State Initiatives
*States With Implemented Medicaid 1115 Waiver Programs
Ch 16: Managed Medicaid Enrollment and Market Share Data
*Managed Medicaid Enrollment Data
*Managed Medicaid Market Share Data
Ch 17: Dir. of Medicaid Plans
Ch 18: Directories of State Medicaid Regulators

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