Resources For Decision Makers

News Release

The National Directory of Healthcare Payers and Providers for Your State Produced

For Immediate Release

“The National Directory of Healthcare Payers and Providers for Your State” has been produced by the Managed Care Information Center.  

The new database product has been developed in response to expressed needs by health-managed care executives, sales and marketing executives, and others who have very focused specific market information needs.

The database for a specific state helps executives connect the health “players” in a state – healthcare systems and their affiliates, physician organizations including IPAs and PHOs, the providers, and managed care organizations – the payers.

The new data product addresses the need for specific information and serves those involved in project and market research-based initiatives.

The database of key C-Suite executive contacts and the organizations’ addresses, and business information is drawn from three major databases produce by the MCIC – The National Directory of Managed Care Organizations Database, The National Directory of Health Systems, Hospitals and Their Affiliates Database and,The National Directory of Physician Hospital Organizations Database.

The database files also include more than 90 percent of the organizations’ web site addresses.

 Besides using the HMO, health system or IPA-PHO database to get current contact names, users can also determine the size of a health plan, health system or physician organization and that entity’s service area, often down to the county level, and the names of the individuals that they need to be in touch with.

The National Directory of Managed Care Organizations Database includes in-depth details on more than 1,170 managed care organizations currently operating in the U.S.  listings of health maintenance organizations (HMOs), a list of preferred provider organizations (PPOs), Consumer Driven Health Plans (CDHP), Health Savings Accounts (HSAs), Medicare Part D plans, point-of-service plans (POS), and several other types of managed care organizations.

The National Directory of Health Systems, Hospitals and Their Affiliates Database file includes full profile information on more than 786 health systems, almost 3,945 Hospitals and almost 12000 hospital system affiliates.

These are the major hospital and health systems nationwide. The system affiliates include hospitals, hospices, home healthcare agencies, nursing homes, and ambulatory care facilities. The list of affiliates provides critical information prior to making a sales call.

The National Directory of Physician Organizations Database contains information on 1374 physician organizations including independent practice associations, (IPAs,) physician hospital organizations (PHOs) multi-specialty medical groups and primary care networks.

The data profiles include key executive contact information, demographics, market area, numbers of physicians and specialist physicians in the organization, and hospital affiliations.

To view complete details about the National Directory of Healthcare Payers and Providers for Your State click on this link: https://healthresourcesonline.com/the-national-directory-of-healthcare-payers-and-providers-for-your-state.html

For more information contact the Managed Care Information Center 1-800-516-4343 or email info@healthresourcesonline.com.

– 30 –

NEWS RELEASE

For Immediate Release

New 2014 Edition of Database Provides Overview of Managed Care Organizations Market

Freshly updated 2014 edition of National Directory of Managed Care Organizations Database produced; latest mergers, acquisitions, promotions and appointments included

WALL, N.J. — The 2014 edition of the National Directory of Managed Care Organizations has been published by the Managed Care Information Center.

The unique database provides market intelligence information on more than 1176 managed care organizations representing 5,279 health insurance plan products.

The new edition includes listings of all managed care companies including health maintenance organizations (HMOs), preferred provider organizations (PPOs), consumer driven health plans (CDHPs), health savings accounts (HSAs), point-of-service plans (POS), and several other types of managed care organizations.

The directory database also covers specialty HMOs and PPOs, and includes details on TPAs, PSOs, POSs, EPOs, Medicare and Medicaid health insurance plans, and Medicare Advantage Health plans and Medicare Part D prescription plans.

The directory is known for providing more “need to know” details in the managed care organization profiles presented.

Organization profiles include the health insurance company’s main address, telephone, fax, web site address and key executive officers.

To help users ‘size’ a market, the directory includes the number of primary care physicians and specialist physicians in the managed care company network; and the number of hospitals with which the health plan has contracts.

The database includes such key contact names as CEO, CFO, COO, medical director, and CIO\MIS director. Also, the name of the parent organization, the year the organization was founded, and its profit-not-for-profit status.

The National Directory of Managed Organizations Database is delivered on CD-Rom.

For complete details on the new edition visit:

The National Directory of Managed Care Organizations Database

Address: The Managed Care Information Center, PO Box 456, Allenwood, NJ 08720, 1-800-516-4343, Fax 1-292-111, email: info@healthresourcesonline.com.
– 30 –

Guide to Value-Based Reimbursement: Profiting from Payment Bundling, PHO Shared Savings, and Pay for Performance

In healthcare’s post-reform volume-to-value world, payor reimbursement strategies are tipping in favor of providers who can deliver the clinical and financial goods. In the mix are bundled payments, shared savings, pay for performance and bonuses — with some going so far as to restructure organizations for maximum gain.

The Guide to Value-Based Reimbursement: Profiting from Payment Bundling, PHO Shared Savings, and Pay for Performance explores emerging models of episode-based payments, physician-hospital organizations and physician bonus structures.

Chapter 1: Blueprint for Bundled Payments
Chapter 2: 7 Key Elements for PHO Success
Chapter 3: Physician Pay-for-Performance and Bonus Structure                                                         http://store.hin.com/product.asp?itemid=4704

Guide to Accountable Care Organizations

Participation in accountable care organizations has more than doubled in the last 12 months, according to recent market data, with the number of commercial and Medicare ACOs expected to reach 500 before the end
of 2013.

One-fifth of healthcare organizations see
the ACO model — a group of healthcare
providers who are rewarded for value
rather than volume of care — as having
the greatest potential to reduce
healthcare cost trend and improve the
quality of care delivery, just behind the
patient-centered medical home.

For more information or to order your copy today please click on this link now:
Guide to Accountable Care Organizations

The Guide to Accountable Care Organizations lays the groundwork for an ACO program, delivering the following:

  •         A comprehensive set of 2012 ACO benchmarks from 200 companies;
  •         A framework for clinical integration, a key ACO prerequisite that puts participating providers on the same performance and payment page;
  •         Guidelines for physician-led ACOs, a model that has outpaced hospital-led ACOs since accountable care organizations emerged on the healthcare scene a few years ago.

You will get answers to more than 45 critical FAQs on accountable care.

Chapter 1: 2012 Healthcare Benchmarks: Accountable Care Organizations
Chapter 2: Blueprint for ACO Success
Chapter 3: Challenges, Risks and Opportunities in the ACO Model

Applying the best practices contained in the Guide to Accountable Care Organizations will help payors and providers build a foundation of accountable care that will improve health outcomes, help to bend the cost trend and boost both patient and physician satisfaction.

Order your  copy today please click on this link now:
Guide to Accountable Care Organizations

Essential Guide to Physician-Hospital Organizations: 7 Key Elements for PHO Success

Healthcare’s value-based reality has changed the rules of organizational alignment. Today, emerging payment models like accountable care organizations (ACOs), bundled payments and shared savings encourage hospitals and physicians to work together and make each more accountable for the other’s actions.

The Essential Guide to Physician-Hospital Organizations: 7 Key Elements for PHO Success describes the seven critical areas of PHO development, from defining the PHO mission to creating a data environment conducive to registry use, analytics and active patient management.

For more information or to order your copy today:
http://store.hin.com/product.asp?itemid=4636

This information-packed 25-page resource describes the changing payor environment and the incentives available to providers.

You’ll get practical considerations for creating a culture of collaboration with the PHO and engaging both providers and employers in this emerging model.

Healthcare thought leaders Travis Ansel, MBA, manager of strategic services, Healthcare Strategy Group, and Greg Mertz, MBA, FACMPE, director of consulting operations, Healthcare Strategy Group, guide readers through the retooled post-reform PHO model.

This Comprehensive Guide Provides Details On:

  • Contrasting the ACO and PHO models;
  • Navigating safe harbor and Stark regulations when designing a PHO;
  • Developing a compensation model that is a win/win for both the physicians and the hospital;
  • Creating the appropriate mix of physicians in terms of numbers and type of physician for effective outcomes and savings;
  • Sharing data effectively and efficiently across the organization;
  • Changing the healthcare consumption patterns for the chronically ill to generate savings;
  • Moving the culture of physicians and hospitals to a value-based healthcare system;
  • and much more.

For more information or to order your copy today call 1-800-516-4343. Or please click here now: http://store.hin.com/product.asp?itemid=4636

Moving Forward with Payment Bundling

With the recent announcement of 500 provider organizations selected to participate in the Bundled Payments for Care Improvement initiative, believed to be the largest demonstration project ever run by CMS, both payer and provider interest in the adoption of payment bundling is at an all-time high.

Moving Forward with Payment Bundling features Jay Sultan, associate vice president and chief product portfolio architect for Trizetto. Sultan provides perspectives on the emerging bundled payment trend, including:

  • An overview of payment bundling rationale, trends, and outcomes. Why does payment bundling work? What is the evidence that it works?;
  • Specific administrative and organizational challenges created with bundled payment programs for healthcare payers, such as contracting challenges, processing claims and payments under payment bundling, and problems with product design and member responsibility; and
  • Address provider issues with bundled payments, including the importance of clinical transformation, forms of organization among providers delivering an episode of care, and administrative requirements around payment and incentive processing.

Order a CD recording, Training DVD, or the On-Demand Version of this event.
http://store.hin.com/product.asp?itemid=4572

The CD, Training DVD and On-Demand version include all presentation handouts.

Jay Sultan shares the experiences of bundled payments programs to date, along with the key steps in getting past the barriers to successful bundled payment programs.

To order or for more information 800-516-4343 or online at:
http://store.hin.com/product.asp?itemid=4572

Avoiding the Readmissions Penalty Zone: Population Health Management for High-Risk Populations

Still smarting from $280 million in penalties levied by CMS in FY 2013, hospitals and health systems can’t afford to take time out from efforts to reduce avoidable hospital readmissions in the Medicare population.

Avoiding the Readmissions Penalty Zone: Population Health Management for High-Risk PopulationsAvoiding the Readmissions Penalty Zone: Population Health Management for High-Risk Populations delivers winning process improvements and interventions that can help organizations make measurable progress toward reducing readmissions in high-risk populations, including a look at a health system-SNF network that has curbed rehospitalizations and length of stay for participants.

In 2012, CMS reduced reimbursement for 2,217 hospitals for excess 30-day readmission ratios related to AMI, heart failure and pneumonia. CMS plans to expand not only the list of target conditions but also its focus on the quality of hospitals’ transitional care — the handoff of patients from one care site to another.

For more information or to order your copy today:
http://store.hin.com/product.asp?itemid=4573

This 40-page resource opens with cross-continuum tactics to lessen the financial impact of the CMS Readmission Penalty program from Amy Boutwell, MD, MPP, president of Collaborative Healthcare Strategies, who draws on her experience as co-founder of the IHI STAAR (State Action on Avoidable Rehospitalizations) Initiative. She is also senior physician consultant to the National Coordinating Center for the CMS QIO Care Transitions Theme.

Dr. Boutwell covers these areas:

  • Creating a diversified and stratified approach to reducing readmissions;
  • Developing a practice change culture to respond to clinical conditions that ensures patients are treated at the right site of care;
  • Staying ahead of readmissions data and projected CMS penalties (a 2 percent increase is planned for FY 2014 and a 3 percent increase in fiscal 2015);
  • Reviewing care processes, readmissions and enabling testing and implementing practice improvements to reduce readmissions;
  • Making the improvements needed in reducing readmission while incurring penalties;
  • and much more.

Dr. Boutwell advises hospitals to monitor what goes on across its care continuum and to partner with facilities it discharges to most often to reduce 30-day readmissions. Summa Health System has done just that with the development of its Care Coordination Network, a community partnership with skilled nursing facilities (SNFs), that is reducing hospital readmission rates and average length of stay for patients transferred to these SNFs.

Avoiding the Readmissions Penalty Zone: Population Health Management for High-Risk Populations presents this case study in reducing SNF-to-hospital readmissions. Carolyn Holder, manager of transitional care for Summa Health System and Michael Demagall, administrator of Bath Manor & Windsong Care Center, two SNFs participating in the network, describe the partnership:

  • Three key areas that improved care transitions between Summa’s hospitals and SNFs in its community;
  • Strategies implemented by Summa to address the key hospital-to-SNF transition challenges;
  • Steps in developing a QI process that monitors transitions to identify weaknesses in the care transition process; and
  • Development and enhancement of the partnership as the hospital system works toward development of an ACO.

For more information or to order your copy today, click here now:
http://store.hin.com/product.asp?itemid=4573

The Role of Case Managers in Emerging Care Delivery Models

With the continued expansion of patient-centered medical homes and accountable care organizations, case managers are taking on a more standardized, collaborative approach to care coordination.

During The Role of Case Managers in Emerging Care Delivery Models, a 45-minute webinar, Teresa Treiger, RN-BC, MA, CHCQM-CM/TOC, CCM, president, Ascent Care Management, provides perspectives on the changing healthcare landscape for case management and care coordination.

  • How case managers’ responsibilities are developing as payment and care delivery models evolve;
  • Achieving physician buy-in and collaboration with case managers on the patient-care team;
  • Developing effective patient-centered care teams inclusive of clinical and non-clinical roles;
  • Maximizing the use of technology in case management to manage the patient care plan; and
  • Emerging trends in case management, including embedding case managers at large employer work sites and strategies for improving care collaboration.

Order a CD recording, Training DVD, or the On-Demand Version of this event.
http://store.hin.com/product.asp?itemid=4563

Healthcare Trends & Forecasts in 2013: Performance Expectations for the Healthcare Industry

Healthcare Trends & Forecasts in 2013: Performance Expectations for the Healthcare Industry, HIN’s ninth annual industry forecast, provides sector-specific guidance for the next 12 months from three key thought leaders.In this eagerly anticipated annual planning tool, Steven T. Valentine, president of The Camden Group, returns to parse the industry landscape for healthcare providers. He covers the top-of-mind issues for physicians and hospitals, including the new mantra of IHI’s Triple Aim, and the emergence of continuum-driven and integrated delivery systems like accountable care organizations, clinically integrated networks and the new business and payment models that support them.To prepare payors for the year ahead, Valentine is joined by Hank Osowski, managing director of Strategic Health Group, and Dennis Eder, also a managing director at Strategic Health Group, who suggest how health plans can best position themselves for a profitable 2013.For more information or to order your copy today, please visit:
http://store.hin.com/product.asp?itemid=4550Performance Expectations for the Healthcare Industry
Osowski and Eder assess the regulatory environment, earnings potential, industry consolidation, health insurance exchanges and opportunities related to care coordination and population health management, particularly for dual eligibles.The advice in this 35-page resource is supplemented with data from HIN’s ninth annual HIN Healthcare Trends and Forecasts survey administered in October 2012. More than 150 responding healthcare organizations identify the top issues facing them today, predict the impact of 2013 ACA mandates on business, and share the best and worst business decisions of 2012 and the lessons learned from both.Healthcare Trends & Forecasts in 2013: Performance Expectations for the Healthcare Industry is a highly respected and anticipated resource highlighting the challenges that will continue to consume the healthcare executive in the year ahead.Now in its ninth year of providing healthcare executives with a look ahead to help shape strategic plans, this year’s resource covers:
  • How the economic environment is continuing to impact the healthcare industry, in terms of the unemployment rate, the uninsured and underinsured, access to credit and soft volume for healthcare services;
  •  How healthcare organizations can prepare for the health reform changes required in 2013 and 2014, including the health insurance exchanges and the dual eligible coordination of care pilots;
  • The impact of the current regulatory environment on hospitals, health plans and medical groups;
  •  How ACOs, the patient-centered medical home, bundled payments, narrow networks and efforts to bend the cost curve will impact the industry in the year ahead;
  •  How the consolidation of hospitals, medical groups and health plans is impacting the industry;
  •  The impact of the 2012 presidential election on the healthcare system;
  •   What healthcare opportunities exist and what actions are needed by healthcare organizations to have a successful 2013.

View the full table of contents and order your copy today at:
http://store.hin.com/product.asp?itemid=4550  

46 Healthcare Metrics to Boost Profitability: Charting 2013 Trends

As ACA initiatives roll out for the third consecutive year, HIN has assembled an actionable and concise data set on 10 key programs: accountable care organizations, patient-centered medical home, population health management, reduction of hospital readmissions and avoidable ER visits, case management, and much more.

46 Healthcare Metrics to Boost Profitability: Charting 2013 Trends is HIN’s second annual graphic compendium of performance benchmarks in key areas of healthcare activity and growth, a desktop reference for the healthcare C-suite that distills emerging trends into easy-to-digest charts and tables.

THIS ALL-NEW 2013 EDITION provides program components, essential tools, success measures, ROI, and many other valuable data.

For more information or to order your copy today:
http://store.hin.com/product.asp?itemid=4536

New for 2013: benchmarks in health coaching, diabetes management and asthma management. Pre-publication discount on 46 Healthcare Metrics to Boost Profitability: Charting 2013 Trends

This 70-page desktop resource is designed exclusively for the busy healthcare executive who seeks a high-level summary of industry trends and metrics. 46 Healthcare Metrics to Boost Profitability: Charting 2013 Trends delivers charts and tables on 46 actionable metrics carefully curated from 2012 market research data by the Healthcare Intelligence Network.

These charts and tables are enhanced by commentary and interviews with industry thought leaders from Aetna, Buck Consultants, HealthFitness, the IHI’s STAAR hospital readmissions initiative, Strategic Health Group, Horizon Blue Cross Blue Shield of NJ, and other organizations at the cutting edge of healthcare delivery.

Order your copy today now while its on your mind:
http://store.hin.com/product.asp?itemid=4536

Physician Hospital Organizations: Developing a Collaborative Structure for Shared Savings Agreements

As payors and large employers aggressively look to hospitals and physicians to move from volume to value of healthcare services, the industry is seeing a resurgence in physician hospital organizations (PHOs)

With an eye toward shared savings agreements, PHOs provide a collaboration tool for physicians and hospitals to organize and participate in these evolving healthcare payment and delivery models.

You will get details on how to:

  •     Navigate safe harbor and Stark regulations when designing a PHO;
  •     Develop a compensation model that is a win/win for both the physicians and the hospital;
  •     Create the appropriate mix of physicians in terms of numbers and type of physician for effective outcomes and savings;
  •     Share data effectively and efficiently across the organization; Change the healthcare consumption patterns for the chronically ill to generate savings; and
  •     Move the culture of physicians and hospitals to a value-based healthcare system.

For complete details or to register today contact 800-516-4343 or visit:
http://store.hin.com/product.asp?itemid=4544

Just Released – 2012 Healthcare Benchmarks: Population Health Management

This new special report delivers an in-depth analysis of population health management (PHM) trends, including prevalence of PHM initiatives, program components, professionals on the PHM team, incentives, challenges and ROI.

This resource analyzes the responses of 102 healthcare organizations to HIN’s industry survey on PHM trends, administered in September 2012. It delivers the latest metrics and measures on current and planned PHM initiatives, providing actionable data on the most effective PHM tools and workflows, risk identification strategies, tools to boost health plan member and consumer engagement, modalities for program delivery, and much, much more.

This 50-page report is designed to meet business and planning needs of health plans, employers, managed care organizations, health systems and others by providing critical benchmarks in population health management.

For complete information please click on this link now: http://store.hin.com/product.asp?itemid=4528

38 Disease Management Metrics: Population Health Benchmarks to Drive Accountable Care

Through a series of 38 graphs and charts, this 35-page resource dives deep into several years of market research to document the role and outcomes of disease management in 11 key areas, as well as the high-focus diseases and health conditions of these initiatives:

  • Obesity and Weight Management
  • Diabetes Management
  • Healthcare Case Management
  • Medication Adherence
  • Reducing Hospital Readmissions
  • Care Transitions Management
  • Patient Registries
  • Health Risk Assessments
  • Reducing Avoidable Emergency Room Visits
  • Health and Wellness Incentives
  • Health Coaching  

For more information or to order your copy today please click on this link now:
http://store.hin.com/product.asp?itemid=4427

Population Health Management: Achieving Results in a Value-Based Healthcare System

Employers, health plans and physician practices are being charged with managing the health of the population they serve under an increasingly value-based healthcare system.
From low-risk patients to chronic, acute-risk patients, healthcare organizations must develop strategies
for stratifying, communicating and engaging patients in population health management programs.

You will get the types of population health management programs and how these programs can produce tangible results in terms of improved outcomes and costs savings including:

  •     The key factors in achieving results from population health management initiatives;
  •     Data collection and risk stratification strategies to optimize population health management results;
  •     Communication strategies to engage consumers in population health management; and
  •     Results from population health management programs.

For complete details please click on this link now: http://store.hin.com/product.asp?itemid=4492



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