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 ContentsCh 1: MA Market Developments*MA Market Expansions*Mergers and Acquisitions*Private-Fee-for-Service Plans*Special Needs Plans*Alliances With ACOsCh 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 AlliancesCh 3: Bid Submissions, Evaluations and Denials*Meaningful Differences Among Products*Bid Strategies, Challenges and Results*Bid Denials and ViolationsCh 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 PlansCh 5: Costs and Premiums for MA and Part D*Payment Rate Cuts*Rising Premiums*Cost SavingsCh 6: MA Plan Audits*Data Validation*RADVCh 7: New MA Data Reporting Requirements*Regulatory Burdens*RACs*Encounter Data ReportingCh 8: MA Star Ratings and Other Quality Initiatives*Criteria and Measures for Quality Ratings*Quality Bonuses*Flagging Poor Performers*NCQA RankingsCh 9: Medicare Managed Care Enrollment Trends and Market Share DataCh 10: Medicare Part D Prescription Drug Data*Enrollment Data*Federal Retiree Drug Subsidy*Low-Income Subsidy*Directory of PDPs Sorted by Parent OrganizationCh 11: Regional Managed Medicare Marketplace DataCh 12: MA Plan Directory*MA, Cost, PACE and Demonstration PlansCh 13: Dir. of Federal and Regional Medicare RegulatorsCh 14: Managed Medicaid Business Strategies and Developments*Medicaid Plans Expansion*Contract Decisions*Mergers and Acquisitions*Payment Rate Changes*Legal ConflictsCh 15: Managed Medicaid Developments in States*State Initiatives*States With Implemented Medicaid 1115 Waiver ProgramsCh 16: Managed Medicaid Enrollment and Market Share Data*Managed Medicaid Enrollment Data*Managed Medicaid Market Share DataCh 17: Dir. of Medicaid PlansCh 18: Directories of State Medicaid Regulators
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Price: $ 443.00
Medicaid and Long Term Care in Michigan: Getting Good Care Without Going Broke
Medicaid and Long-Term Care in Michigan is an information and resource guide to the long-term care options available in Michigan, that addresses how to pay for that care without going broke. This invaluable book reveals state of the art techniques to qualify for Medicaid – the government program that pays for long-term nursing home care – while preserving one’s nest egg. Detailed text including case studies shows you how to keep what you’ve worked for your whole life in the event you or a loved one needs long-term care. Each chapter contains numerous websites and resources to help the reader obtain the best care available without losing everything.
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Medicaid And The Limits of State Health Reform
With the defeat of national health reform, many liberals have looked to the states as the source of health policy innovation. At the same time, many in the new Republican majority and several governors also support increased state control. In contrast, Michael S. Sparer convincingly argues that states by themselves can neither satisfy the liberal hope for universal coverage nor the conservative hope for cost containment. He also points to two critical drawbacks to a state-dominated health care system: the variation in coverage among states and the intergovernmental tension that would inevitably accompany such a change. Supporting his arguments, Sparer analyzes the contradictions in operations and policies between the New York and California Medicaid programs. For instance, why does New York spend an average of ,286 on its Medicaid beneficiaries and California an average of ,801? The answer, the author suggests, is rooted in bureaucratic politics. California officials enjoy significant bureaucratic autonomy, while the system in New York is fragmented, decentralized, and interest-group dominated. The book supports this conclusion by exploring nursing home and home care policy, hospital care policy, and managed care policy in the two states. Sparer’s dissection of the consequences of state-based reform make a persuasive case for national health insurance. Author note: Michael S. Sparer is Assistant Professor of Health Policy in the School of Public Health at Columbia University.
List Price: $ 29.95
Price: $ 29.95
Medicaid and Devolution: A View from the States
How much responsibility for providing health care to the poor should be devolved from the federal government to the states? Any answer to this critical policy question requires a careful assessment of the Medicaid program. Drawing on the insights of leading scholars and top state health care officials, this volume analyzes the policy and management implications of various options for Medicaid devolution.
Proponents of devolution typically express confidence that states can meet the challenges it will pose for them. But, as this book shows, the degree to which states have the capacity and commitment to use enhanced discretion to sustain or improve health care for the poor remains an open question. Their failure to attend to issues of politics, implementation, and management could lead to disappointment. Chapters focus on such topics as Medicaid financing, benefits and beneficiaries, long-term care, managed care, safety net providers, and the appropriate division of labor between the federal government and the states.
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Price: $ 18.66
Medicaid Financial Eligibility Rules for Nursing Home Care in New York State
This reference guide was written to help people gain quick access to the rules which determine whether Medicaid will pay for someone’s nursing home care. It focuses specifically on the financial eligibility rules for New Yorkers who are 65 and older. Topics include: spouse’s responsibility; resource levels; exempt resources; resources which receive special treatment; gifting and penalty periods; exempt transfers; and trusts. It contains extensive citations to: NY statutes; NY Codes, Rules & Regulations; Administrative Directives; Informational Letters; GIS Messages; and the newly-repaginated Medicaid Reference Guide.
List Price: $ 26.50
Price: $ 26.50
New York Elder Law Handbook (March 2011 Edition)
Thousands of advocates for older, blind, and disabled New York State residents rely on PLI’s New York Elder Law for useful, authoritative guidance on the legal issues confronting their clients and on the ways these practitioners can work more effectively with various federal and state agencies to help their clients.
New York Elder Law taps experts in their respective fields to cover the latest legal issues and pertinent figures with regard to Social Security; Supplemental Security Income; Social Security and SSI Disability; Medicare; Supplemental Medical Insurance; Medicaid for the elderly, blind and disabled; home care; protective services; housing; nursing homes; health care decision-making; veteran’s benefits; and retirement plans.
New York Elder Law contains numerous checklists to save you time and help you stay up to speed with rapidly changing laws and numbers, including up-to-date eligibility and benefit levels, benefit checklists for older adults, and flow charts for step-by-step guidance through complex appeals processes.
Updated at least once a year, New York Elder Law is an essential handbook for attorneys, health care professionals, social workers, financial planners, and other advocates for older clients.
Founded in 1933, Practising Law Institute (Practicing Law Institute, PLI) is the nation’s foremost provider of continuing legal education. PLI is a leading publisher of authoritative legal references and other information resources and offers more than 300 live and electronic programs nationally.
About the Author
Sadin Institute on Law & Public Policy of the Brookdale Center for Healthy Aging and Longevity, Hunter College/City University of New York has been in operation since 1977 as a legal support system for advocates who serve the elderly. It is a past recipient of the National Academy of Elder Law Attorney’s President’s Recognition Award for lasting contributions in the field of elder law and in advocating for the elderly.
Thousands of advocates for older, blind, and disabled New York State residents rely on PLI’s New York Elder Law for useful, authoritative guidance on the legal issues confronting their clients and on the ways these practitioners can work more effectively with various federal and state agencies to help their clients.
New York Elder Law taps experts in their respective fields to cover the latest legal issues and pertinent figures with regard to Social Security; Supplemental Security Income; Social Security and SSI Disability; Medicare; Supplemental Medical Insurance; Medicaid for the elderly, blind and disabled; home care; protective services; housing; nursing homes; health care decision-making; veteran’s benefits; and retirement plans.
New York Elder Law contains numerous checklists to save you time and help you stay up to speed with rapidly changing laws and numbers, including up-to-date eligibility and benefit levels, benefit checklists for older adults, and flow charts for step-by-step guidance through complex appeals processes.
Updated at least once a year, New York Elder Law is an essential handbook for attorneys, health care professionals, social workers, financial planners, and other advocates for older clients.
Founded in 1933, Practising Law Institute (Practicing Law Institute, PLI) is the nation’s foremost provider of continuing legal education. PLI is a leading publisher of authoritative legal references and other information resources and offers more than 300 live and electronic programs nationally.
About the Author
Sadin Institute on Law & Public Policy of the Brookdale Center for Healthy Aging and Longevity, Hunter College/City University of New York has been in operation since 1977 as a legal support system for advocates who serve the elderly. It is a past recipient of the National Academy of Elder Law Attorney’s President’s Recognition Award for lasting contributions in the field of elder law and in advocating for the elderly.
List Price: $ 195.00
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Medicaid Asset Protection Plan (MAPP)
- Learn how patients can qualify for Medicaid, while protecting assets, even if
- Learn how (using approved Federal and State MEDICAID eligibility rules) to transfer assets and qualify for nursing home or other long-term care MEDICAID – quickly!
- The Financial Aid Center For Long Term Care has helped Thousands save $Millions$!!!, and we can show you how to legally protect assets from Medicaid for your family, even if you’re already in a nursing home.
- We’ve helped thousands of families qualify for Medicaid while saving millions of dollars – people just like you.
- Your MAPP DRA Video Package will contain specific Medicaid information for every state.
The MAPPTM DRA Video Package includes all of the following ……
A professionally produced video (2 DVDs). The first DVD contains lessons carefully designed to teach you the key Medicaid asset protection concepts, with plenty of examples and illustrations. The second DVD includes bonus sections on taxes, legal documents (wills, trusts, etc.), record keeping, meeting with the Medicaid worker and much more. A booklet containing additional information and reference material to supplement the video. State-specific Medicaid information for every state. A worksheet to help you gather and organize the patient’s information. A set of convenient envelopes, custom-designed to hold the patient’s records, receipts and other important papers. A large deluxe custom binder to keep everything contained and organized for you.
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Elder Law in New Jersey: Finding Solutions for Legal Problems
In New Jersey, one in five residents is over the age of sixty-five. The Garden State’s legal and health care systems are becoming increasingly complex, making it more difficult than ever for seniors to understand their rights and take advantage of available assistance and services. Elder Law in New Jersey provides important, practical information to New Jersey residents. Many individuals will benefit from reading this book: older adults who have become entangled in a web of health care and social security bureaucracies, younger adults who are caregivers to elderly parents, and middle-class citizens who fear the debilitating physical and financial effects of chronic illness. The legal problems most often encountered by seniors can involve frustrating losses of control over nearly all aspects of their lives. Attorney Alice K. Dueker, who specializes in elder law, explains complex legal issues in easily understood language. She also provides contact information for agencies and programs that provide free or low-cost services for seniors and resources for locating attorneys. Elder law is state specific, so New Jersey residents will find this book especially helpful and applicable to their own lives. Alice K. Dueker is an attorney and the director of clinical programs at the Rutgers University School of Law-Camden, where she supervises the Civil Practice Clinic’s Elder Law Project.
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Price: $ 11.00
Medicaid Everyone Can Count On: Public Choices for Equity and Efficiency
Health-care programs for the poor should be based on principles of equity, efficiency, and democracy. Medicaid and the State Children’s Health Insurance Program (SCHIP) fall far short of this ideal. This volume outlines an approach to reform based on equal distribution of benefits across states, efficient allocation of resources, and policy choices that reflect the interests of voters and taxpayers. Thomas W. Grannemann and Mark V. Pauly emphasize controlling and redirecting the flow of resources as the key to meaningful reform.
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Price: $ 24.11
Kiplinger’s Estate Planning: The Complete Guide to Wills, Trusts, and Maximizing Your Legacy
If I don’t have an estate plan, what will happen when I die? Can I plan my own estate, or should I work with an estate attorney? How can I make sure that my estate isn’t whittled away by state and federal taxes?
In Kiplinger’s Estate Planning, financial expert and attorney John Ventura offers straightforward guidance on all of the tools of estate planning, from wills, trusts, and custodial accounts to insurance, employee befits, and durable power of attorney for finance and health care.
In this easy-to-read guide, learn: What you can and can’t do with a will; How a living trust works; Your options for transferring assets to your spouse or partner; How to give your assets away while you are alive; How to use a durable power of attorney for health care—and what will happen if you become incapacitated without one; Controlling your death with a living will; How to leave a personal legacy; How to complete the process on your own or work with an estate attorney
List Price: $ 21.95
Price: $ 12.46