Easy-to-use, continually updated database allows you to quickly see a wealth of information on nearly 600 plans serving Medicare-Medicaid dual eligibles under a variety of programs. Included for each plan:
Health plans can assess which states may provide new opportunities to participate in either CMS-backed or states’ own duals initiatives.
Market-research managers can determine which states are farthest along in developing integration initiatives for duals and how that affects the public-sector markets for health plans.
Financial executives can see savings targets, withhold rates and capitation rates to assess whether duals plans are likely to achieve their — and government agencies’ — financial objectives.
Duals plan operators can track strategies and results of other duals plans in their own markets and in other states.
Behavioral-health companies and pharmacy benefit managers can find out what each duals program needs and already has done in those specialty areas.
Insurers’ contract negotiators can compare the provisions of the Memorandum of Understanding each plan in the federal duals demo has with both CMS and the state involved.
Pharmaceutical manufacturers can find out the potential market for their products in the new duals plans and contact information for plan officials.
Product developers can view opt-out rates and special program requirements that can help when designing future programs, including at the state level, for duals.
Compliance directors and attorneys can search laws and Memorandums of Understanding to ensure they understand and are obeying duals-program requirements.
AIS editors cover the entire health insurance landscape to identify and track all programs and plans involved in serving dual-eligible populations. Sources currently include:
• Centers for Medicare and Medicaid Services (CMS),
• State agencies with initiatives to coordinate dual-eligibles’ care and reimbursement,
• Health plans operating dual-eligibles plans,
• Vendors and consultants working with dual-eligibles plans