AIS’s Directory of Health Plans is the most comprehensive resource available on the U.S. health plan market with enrollment data and contact information for health plans and primary care preferred provider networks operating in the U.S. as of year-end 2011. The database is also available on CD to permit the creation of the specific analysis that suits the needs of each user. View Episode 1 for more information about what is included in AIS’s Directory of Health Plans.
Best Practices: Cutting Through the Confusion & Avoiding the Pitfalls of Crea...dclsocialmedia
This document provides guidance on best practices for creating Structured Product Labeling (SPL) and Affordable Care Act 6004 files submitted to the FDA, including ensuring accurate information. It outlines key areas to validate such as labeler, registrant and establishment data, drug product information, LOINC codes, and links to FDA resources. The objectives are to minimize pitfalls and demonstrate how regulations can be enforced through electronic submission of accurate information.
Facebook offers several products and services to help retailers engage customers and drive sales, including Facebook Exchange (FBX), Custom Audiences, mobile app install ads, and offers. FBX allows retailers to buy and sell inventory through Facebook at 2x the conversion rate and 6.5x lower cost per action than other channels. Custom Audiences allows targeting existing customers and prospects, increasing sign-up conversions by 43% and reducing cost per lead by 30%. Mobile app install ads and offers can also boost in-store and online sales when used as part of a multi-channel campaign. Case studies showed retailers seeing 130% online sales uplift and other metrics like 80% year-over-year revenue increase from Facebook initiatives.
El documento habla sobre una organización llamada "ASOGLOPIP" y la "Policía de Investigaciones del Perú". Menciona que son uno solo y que estarán juntos por siempre. No provee más detalles sobre estas organizaciones o el contenido del documento.
Seamless customer experience management bucharest 26th november 2013Ruben Spekle
Presentation given at the Oracle Customer Xperience Day in Bucharest on the 26th of November. Why ZMOT starts the journey on digitalization and All Channel Experience and how Oracle Products fit in this.
Innovation in bank payment systems and related services among selected commer...Alexander Decker
This document discusses innovations in bank payment systems among commercial banks in Ghana. It finds that innovations like automated teller machines, telephone banking, internet banking, mobile banking, debit/credit cards, and e-zwich have contributed positively to banking services and growth. However, problems still exist like security issues with new payment methods and losing of customer trust. The document aims to evaluate customer perceptions of these innovative payment systems and their impact on banking behavior and identifies constraints faced by customers.
Med e hub - e-library for healthcare reimbursement - january13Lisa Blanton
This document summarizes the services provided by the Evergreen Consulting Library for Healthcare Reimbursement & Economics (Med-eHUB). It provides 24/7 access to focused, up-to-date research on reimbursement and healthcare economics through an interactive, customizable online portal. Subscribers gain efficiencies over traditional written reports through continuous updates and the ability to build custom modules. The portal includes state-by-state Medicaid details, events calendars, legislation dashboards, and customized tracking reports on policies, programs, and more.
Best Practices: Cutting Through the Confusion & Avoiding the Pitfalls of Crea...dclsocialmedia
This document provides guidance on best practices for creating Structured Product Labeling (SPL) and Affordable Care Act 6004 files submitted to the FDA, including ensuring accurate information. It outlines key areas to validate such as labeler, registrant and establishment data, drug product information, LOINC codes, and links to FDA resources. The objectives are to minimize pitfalls and demonstrate how regulations can be enforced through electronic submission of accurate information.
Facebook offers several products and services to help retailers engage customers and drive sales, including Facebook Exchange (FBX), Custom Audiences, mobile app install ads, and offers. FBX allows retailers to buy and sell inventory through Facebook at 2x the conversion rate and 6.5x lower cost per action than other channels. Custom Audiences allows targeting existing customers and prospects, increasing sign-up conversions by 43% and reducing cost per lead by 30%. Mobile app install ads and offers can also boost in-store and online sales when used as part of a multi-channel campaign. Case studies showed retailers seeing 130% online sales uplift and other metrics like 80% year-over-year revenue increase from Facebook initiatives.
El documento habla sobre una organización llamada "ASOGLOPIP" y la "Policía de Investigaciones del Perú". Menciona que son uno solo y que estarán juntos por siempre. No provee más detalles sobre estas organizaciones o el contenido del documento.
Seamless customer experience management bucharest 26th november 2013Ruben Spekle
Presentation given at the Oracle Customer Xperience Day in Bucharest on the 26th of November. Why ZMOT starts the journey on digitalization and All Channel Experience and how Oracle Products fit in this.
Innovation in bank payment systems and related services among selected commer...Alexander Decker
This document discusses innovations in bank payment systems among commercial banks in Ghana. It finds that innovations like automated teller machines, telephone banking, internet banking, mobile banking, debit/credit cards, and e-zwich have contributed positively to banking services and growth. However, problems still exist like security issues with new payment methods and losing of customer trust. The document aims to evaluate customer perceptions of these innovative payment systems and their impact on banking behavior and identifies constraints faced by customers.
Med e hub - e-library for healthcare reimbursement - january13Lisa Blanton
This document summarizes the services provided by the Evergreen Consulting Library for Healthcare Reimbursement & Economics (Med-eHUB). It provides 24/7 access to focused, up-to-date research on reimbursement and healthcare economics through an interactive, customizable online portal. Subscribers gain efficiencies over traditional written reports through continuous updates and the ability to build custom modules. The portal includes state-by-state Medicaid details, events calendars, legislation dashboards, and customized tracking reports on policies, programs, and more.
Marketplace Plans What to Expect in 2017 and BeyondEnroll America
The document discusses changes coming to the Affordable Care Act marketplace in 2017 and beyond. It provides an agenda for a session on marketplace plans which includes getting attendees up to speed on quality ratings and standardized plans coming in 2017 and reviewing trends in marketplace plans. Several speakers will discuss NCQA marketplace quality measures and report cards, new plans and tools coming to Healthcare.gov in 2017 including standardized plans and network breadth ratings, and lessons learned from the exchanges over the past three years.
This is an overview about our email based newsletter that is delivered 3-5 times a week. It covers news updates across categories like sales and marketing, legal and regulatory, diseases, international news, research and approvals, etc. Highly recommended for colleagues from marketing and licensing teams.
Myhealth.com is a proposed single platform that connects the Saudi healthcare system by providing internet-based transaction services. It would integrate information from various healthcare providers, insurance companies, and third party administrators onto one platform. This would improve issues like lack of centralized patient records, multiple patient IDs, and manually compiled reports. The platform would allow insurance eligibility checks, online claims processing, standard pricing, and real-time reporting. It has the potential to go paperless, assign unique patient identifiers, and develop apps for patients and providers. Revenue streams are proposed through monthly provider/insurer fees, per-transaction charges, annual maintenance fees, and commissions. The platform aims to streamline the healthcare system and be the first integrated solution in
Provides an overview of our data management and analytics capabilities. Covers areas like internal data management, market research, external market environment assessment, etc.
The Top of Hospital dashboard provides hospital leaders with key performance indicators and data from across the health system in an intuitive display. It allows administrators to see trends in historic data, compare actual and budgeted values, and predict future performance. The dashboard enables leaders to quickly view metrics like hospital admissions, length of stay, surgical volumes, revenue history and projections, and cash on hand, and see how each compares to targets from any device. Administrators can also drill down into details to understand contributions from different business units.
How to improve operating margins
● What does operating margin tell you about the organization, and how would
you calculate this ratio?
● Select a local medical service organization and describe how it has
specifically improved its operating margins.
HFMA
Financial Reporting Function
Financial Reporting Function
Financial Accounting Standards Board
(FASB)
FASB standards rest on certain
assumptions:
Ø Monetary unit
Ø Economic entity
Ø Time period
Ø Going concern
Financial Reporting Function
FASB
Two key principles
Ø Cost principle
Ø Full disclosure principle
Financial Reporting Function
Generally Accepted Accounting Principles
(GAAP)
Ø Consistency
Ø Relevance
Ø Reliability
Ø Comparability
Financial Reporting Function
Financial Statements
For Profit Not-for-Profit
Balance Sheet Statement of Financial
Position
Income Statement Statement of Operations
Statement of Cash Flows Statement of Cash Flows
Financial Reporting Function
Accepted Accounting Methods
Ø Accrual
Ø Cash
Ø Fund
Financial Reporting Function
Financial Statement Presentation
Ø Two years are displayed
- Prior year to the right of the current year
Ø Statement of Operations or Income Statement are for a period of
time—typically a month
Ø Statement of Cash Flows reflects a period of time consistent with the
Statement of Operations or Income Statement—typically a month
Ø Statement of Financial Position or Balance Sheet reflect the status
of Assets, Liabilities, and Net Assets/Shareholders’ Equity as of a
day.
Financial Reporting Function
Ratio Analysis
Ø Liquidity Ratios
Ø Profitability Ratios
Ø Asset Efficiency Ratios
Ø Capital Structure Ratios
Ø Operating Indicators
Financial Reporting Function
Ratio Analysis
Ø Liquidity
- Current ratio
- Quick ratio
Current ratio = Current Assets/Current Liabilities
Quick ratio = (Cash + Marketable Securities + Net
Accounts Receivable)/Current Liabilities
Financial Reporting Function
Ratio Analysis
Ø Profitability
- Operating margin
- Return on assets
Operating Margin = [(Operating Revenue-Operating
Expenses)/Total Operating Revenues] x 100
Return on Assets = Excess of revenues over expenses/
Total Assets
Financial Reporting Function
Ratio Analysis
Ø Asset efficiency
- Total asset turnover
- Inventory turnover
Total Asset Turnover = Total Operating Revenue/ Total
Assets
Inventory Turnover = Total Operating Revenue/ Inventory
Financial Reporting Function
Ratio Analysis
Ø Capital structure
- Debt to Capitalization
- Debt service coverage
Debt to Capitalization = [Long-term Debt/ (Long-term Debt
+ Unrestricted Net Assets)] x 100
Debt Service Coverage = (Excess of revenues over
expenses + Depre.
Healthcare SICG is a consulting group that provides self-insured healthcare plans as an alternative to expensive fully insured plans. It partners with stop loss insurers, universities, employers, physicians, pharmacies, and wellness partners. Healthcare SICG's business model focuses on utilizing technology like apps to promote self-management and increasing patient-clinician interaction while offering customized healthcare plans at a lower cost than traditional insurance through services, usage fees, and brokerage fees. The company's competitive advantage comes from its use of technology, value-added services, and patient satisfaction to differentiate itself in the marketplace at a lower cost.
The podiatrists market consists of sales of podiatrists’ services and related goods by entities (organizations, sole traders and partnerships) that provide podiatry services including diagnosis and treatment of diseases and deformities of the foot .
Developing a Hospital Business Intelligence Strategy Mikan Associates
The document discusses developing a business intelligence (BI) strategy for hospitals in a value-based healthcare system. It defines BI as the ability to collect, analyze, and connect quality and financial data to support decision making. The Healthcare Financial Management Association has identified BI as a key capability for organizations to prepare for value-based care. The document outlines the components of a successful hospital BI strategic plan and discusses how BI can help providers improve efficiency, lower costs, and enhance quality of care.
This document summarizes the key findings of the 2011 Indiana Healthcare Benefit Survey conducted by the actuarial firm Nyhart. The survey analyzed 215 employers and over 350 medical and 220 dental plans. It found that the average cost of single medical coverage increased 6.9% from 2010 to 2011, while the average employer subsidy for single coverage increased 2.5%. Common plan designs included a $50 dental deductible, $1,000 annual dental maximum, and 80% coinsurance for basic medical services. The presentation provides details on plan prevalence, cost trends, and design features to help healthcare actuaries advise clients.
The document summarizes information from the Fallon Community Health Plan's (FCHP) December 2009 newsletter. It discusses FCHP's high rankings in national quality surveys. It also discusses ongoing efforts to reduce rising healthcare costs, including working with providers and employers. FCHP is focused on delivering value and ensuring members receive high quality care.
Mosaic Employee Benefits is an insurance brokerage that has served clients since 1986. It offers a wide range of employee benefits such as retirement plans, health insurance, life insurance, and HR services. Mosaic works with many major carriers and provides customized solutions based on each client's unique needs. It also offers services like an online HR portal and wellness programs through ERC Health to improve benefits and reduce costs.
Knowledge management and business intelligence systems in the pharmaceutical industry can provide access to valuable data and insights. This information can help decision-makers make informed choices regarding drug development, clinical trials, market expansion, and resource allocation.
Enhanced Research and Development: Knowledge management systems enable efficient storage, retrieval, and sharing of scientific knowledge, research findings, and intellectual property. This facilitates collaboration among researchers, accelerates the discovery process, and promotes innovation in drug development.
Effective Drug Discovery and Targeting: Business intelligence tools can analyze vast amounts of data, such as genomic information, clinical trial results, and patient records. This enables pharmaceutical companies to identify potential drug targets, optimize drug discovery processes, and develop personalized treatments based on patient characteristics.
Regulatory Compliance: The pharma industry operates in a heavily regulated environment. Knowledge management systems can centralize regulatory information, track compliance requirements, and ensure adherence to relevant guidelines. This reduces the risk of non-compliance and facilitates regulatory audits and inspections.
Efficient Supply Chain Management: Business intelligence systems can monitor and analyze supply chain data, including inventory levels, production rates, and distribution networks. This helps streamline the supply chain, optimize inventory management, and ensure timely delivery of pharmaceutical products while minimizing costs and waste.
Real-time Market Insights: Knowledge management and business intelligence tools provide real-time access to market data, competitor analysis, and customer feedback. This empowers pharmaceutical companies to identify market trends, understand customer needs, and make data-driven marketing and sales strategies to maximize product adoption and market share.
Patient Safety and Pharmacovigilance: Knowledge management systems enable the collection, analysis, and sharing of adverse drug event data and patient safety information. This supports pharmacovigilance efforts, helps identify potential risks, and facilitates proactive measures to ensure patient safety.
Improved Collaboration and Knowledge Sharing: Knowledge management platforms facilitate collaboration among cross-functional teams, enabling seamless information sharing, best practice dissemination, and lessons learned. This fosters a culture of continuous learning and improvement within the organization.
Cost Reduction and Operational Efficiency: Business intelligence tools can analyze operational data, identify inefficiencies, and optimize processes. This leads to cost reduction, improved resource allocation, and increased operational efficiency across various functions, such as manufacturing, logistics, and sales.
Compliance with Quality Standards: Knowledge management systems assist in ensuring
ORBIS is a comprehensive global database containing information on over 50 million public and private companies worldwide. It combines data from 100+ sources into standardized report formats, allowing for searching and comparisons across different regions and industries. Coverage includes listed companies, banks, insurers, and private European firms. ORBIS also features a unique ownership database linking over 20 million parent and subsidiary relationships. Users can access reports and financials through unlimited or pay-per-view access options.
Write a 4–6-page report for a senior leader that communicates .docxjohnbbruce72945
Write a 4–6-page report for a senior leader that communicates your evaluation of current organizational or interprofessional team performance, with respect to prescribed benchmarks set forth by government laws and policies at the local, state, and federal levels. In addition, advocate for ethical action to address benchmark underperformance and explain the potential for improving the overall quality of care and performance, as reflected on a performance dashboard.
In the era of health care reform, many of the laws and policies set forth by government at the local, state, and federal levels have specific performance benchmarks related to care delivery outcomes that organizations must achieve. It is critical for organizational success that the interprofessional care team is able to understand reports and dashboards that display the metrics related to performance and compliance benchmarks.
Maintaining standards and promoting quality in modern health care are crucial, not only for the care of patients, but also for the continuing success and financial viability of health care organizations. In the era of health care reform, health care leaders must understand what quality care entails and how quality in health care connects to the standards set forth by relevant federal, state, and local laws and policies. An understanding of relevant benchmarks that result from these laws and policies, and how they relate to quality care and regulatory standards, is also vitally important.
Health care is a dynamic, complex, and heavily regulated industry. For this reason, you will be expected to constantly scan the external environment for emerging laws, new regulations, and changing industry standards. You may discover that as new policies are enacted into law, ambiguity in interpretation of various facets of the law may occur. Sometimes, new laws conflict with preexisting laws and regulations, or unexpected implementation issues arise, which may warrant further clarification from lawmakers. Adding partisan politics and social media to the mix can further complicate understanding of the process and buy-in from stakeholders.
Assessment Instructions
Note
: Your evaluation of dashboard metrics for this assessment is the foundation on which all subsequent assessments are based. Therefore, you must complete this assessment first.
Write a report for a senior leader that communicates your evaluation of current organizational or interprofessional team performance with respect to prescribed benchmarks set forth by government laws and policies at the local, state, and federal levels. In addition, advocate for ethical action to address benchmark underperformance and explain the potential for improving the overall quality of care and performance, as reflected on a performance dashboard.
Review the performance dashboard metrics, as well as relevant local, state, and federal laws and policies. Consider the metrics that are falling short of the prescribed benchmar.
The document provides information about the key parts and operation of the Health Insurance Marketplace. It defines the Marketplace and describes the main components including qualified health plans, tax credits, cost sharing reductions, and the roles of assisters. It explains the different types of Marketplaces (Federally-facilitated, State-based, Partnership), essential health benefits, plan categories and actuarial values. The document aims to educate consumers and assisters on how to use the Marketplace to find and enroll in affordable health insurance.
Supplemental and Ancillary Products on Private ExchangesCarol Harnett
Private exchanges are beginning to gain traction as an alternate way to offer employees a way to select and purchase benefits. While vendors and consultants are making progress with private health exchanges, there are still many issues to tackle when it comes to the inclusion of ancillary, supplementary and voluntary benefits.
Unprecedented transformation is reshaping our nation's healthcare delivery system. In this post- ACA environment, providers are increasingly dependent on the government as a payor. At the same time, regulators and governing bodies at the local, state and federal level determine the ever-changing rules and regulations through which providers operate. Through all of this, one thing is clear: having a well-established government relations program has never been more important to achieving a health care organization’s strategic business goals.
Given the increasing role government relations is playing in a health system’s success, leaders across the country are rethinking how they invest in, structure and staff their programs. General counsels at some health systems are very involved in these efforts, others less so. Join us to learn why you and your organization should be assessing your approach to and management of government relations. David Jarrard and Magi Curtis will share industry insights and best practices as well as hard data from a nation-wide benchmark project they recently published that looks at how hospitals and health systems are approaching government relations.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
Marketplace Plans What to Expect in 2017 and BeyondEnroll America
The document discusses changes coming to the Affordable Care Act marketplace in 2017 and beyond. It provides an agenda for a session on marketplace plans which includes getting attendees up to speed on quality ratings and standardized plans coming in 2017 and reviewing trends in marketplace plans. Several speakers will discuss NCQA marketplace quality measures and report cards, new plans and tools coming to Healthcare.gov in 2017 including standardized plans and network breadth ratings, and lessons learned from the exchanges over the past three years.
This is an overview about our email based newsletter that is delivered 3-5 times a week. It covers news updates across categories like sales and marketing, legal and regulatory, diseases, international news, research and approvals, etc. Highly recommended for colleagues from marketing and licensing teams.
Myhealth.com is a proposed single platform that connects the Saudi healthcare system by providing internet-based transaction services. It would integrate information from various healthcare providers, insurance companies, and third party administrators onto one platform. This would improve issues like lack of centralized patient records, multiple patient IDs, and manually compiled reports. The platform would allow insurance eligibility checks, online claims processing, standard pricing, and real-time reporting. It has the potential to go paperless, assign unique patient identifiers, and develop apps for patients and providers. Revenue streams are proposed through monthly provider/insurer fees, per-transaction charges, annual maintenance fees, and commissions. The platform aims to streamline the healthcare system and be the first integrated solution in
Provides an overview of our data management and analytics capabilities. Covers areas like internal data management, market research, external market environment assessment, etc.
The Top of Hospital dashboard provides hospital leaders with key performance indicators and data from across the health system in an intuitive display. It allows administrators to see trends in historic data, compare actual and budgeted values, and predict future performance. The dashboard enables leaders to quickly view metrics like hospital admissions, length of stay, surgical volumes, revenue history and projections, and cash on hand, and see how each compares to targets from any device. Administrators can also drill down into details to understand contributions from different business units.
How to improve operating margins
● What does operating margin tell you about the organization, and how would
you calculate this ratio?
● Select a local medical service organization and describe how it has
specifically improved its operating margins.
HFMA
Financial Reporting Function
Financial Reporting Function
Financial Accounting Standards Board
(FASB)
FASB standards rest on certain
assumptions:
Ø Monetary unit
Ø Economic entity
Ø Time period
Ø Going concern
Financial Reporting Function
FASB
Two key principles
Ø Cost principle
Ø Full disclosure principle
Financial Reporting Function
Generally Accepted Accounting Principles
(GAAP)
Ø Consistency
Ø Relevance
Ø Reliability
Ø Comparability
Financial Reporting Function
Financial Statements
For Profit Not-for-Profit
Balance Sheet Statement of Financial
Position
Income Statement Statement of Operations
Statement of Cash Flows Statement of Cash Flows
Financial Reporting Function
Accepted Accounting Methods
Ø Accrual
Ø Cash
Ø Fund
Financial Reporting Function
Financial Statement Presentation
Ø Two years are displayed
- Prior year to the right of the current year
Ø Statement of Operations or Income Statement are for a period of
time—typically a month
Ø Statement of Cash Flows reflects a period of time consistent with the
Statement of Operations or Income Statement—typically a month
Ø Statement of Financial Position or Balance Sheet reflect the status
of Assets, Liabilities, and Net Assets/Shareholders’ Equity as of a
day.
Financial Reporting Function
Ratio Analysis
Ø Liquidity Ratios
Ø Profitability Ratios
Ø Asset Efficiency Ratios
Ø Capital Structure Ratios
Ø Operating Indicators
Financial Reporting Function
Ratio Analysis
Ø Liquidity
- Current ratio
- Quick ratio
Current ratio = Current Assets/Current Liabilities
Quick ratio = (Cash + Marketable Securities + Net
Accounts Receivable)/Current Liabilities
Financial Reporting Function
Ratio Analysis
Ø Profitability
- Operating margin
- Return on assets
Operating Margin = [(Operating Revenue-Operating
Expenses)/Total Operating Revenues] x 100
Return on Assets = Excess of revenues over expenses/
Total Assets
Financial Reporting Function
Ratio Analysis
Ø Asset efficiency
- Total asset turnover
- Inventory turnover
Total Asset Turnover = Total Operating Revenue/ Total
Assets
Inventory Turnover = Total Operating Revenue/ Inventory
Financial Reporting Function
Ratio Analysis
Ø Capital structure
- Debt to Capitalization
- Debt service coverage
Debt to Capitalization = [Long-term Debt/ (Long-term Debt
+ Unrestricted Net Assets)] x 100
Debt Service Coverage = (Excess of revenues over
expenses + Depre.
Healthcare SICG is a consulting group that provides self-insured healthcare plans as an alternative to expensive fully insured plans. It partners with stop loss insurers, universities, employers, physicians, pharmacies, and wellness partners. Healthcare SICG's business model focuses on utilizing technology like apps to promote self-management and increasing patient-clinician interaction while offering customized healthcare plans at a lower cost than traditional insurance through services, usage fees, and brokerage fees. The company's competitive advantage comes from its use of technology, value-added services, and patient satisfaction to differentiate itself in the marketplace at a lower cost.
The podiatrists market consists of sales of podiatrists’ services and related goods by entities (organizations, sole traders and partnerships) that provide podiatry services including diagnosis and treatment of diseases and deformities of the foot .
Developing a Hospital Business Intelligence Strategy Mikan Associates
The document discusses developing a business intelligence (BI) strategy for hospitals in a value-based healthcare system. It defines BI as the ability to collect, analyze, and connect quality and financial data to support decision making. The Healthcare Financial Management Association has identified BI as a key capability for organizations to prepare for value-based care. The document outlines the components of a successful hospital BI strategic plan and discusses how BI can help providers improve efficiency, lower costs, and enhance quality of care.
This document summarizes the key findings of the 2011 Indiana Healthcare Benefit Survey conducted by the actuarial firm Nyhart. The survey analyzed 215 employers and over 350 medical and 220 dental plans. It found that the average cost of single medical coverage increased 6.9% from 2010 to 2011, while the average employer subsidy for single coverage increased 2.5%. Common plan designs included a $50 dental deductible, $1,000 annual dental maximum, and 80% coinsurance for basic medical services. The presentation provides details on plan prevalence, cost trends, and design features to help healthcare actuaries advise clients.
The document summarizes information from the Fallon Community Health Plan's (FCHP) December 2009 newsletter. It discusses FCHP's high rankings in national quality surveys. It also discusses ongoing efforts to reduce rising healthcare costs, including working with providers and employers. FCHP is focused on delivering value and ensuring members receive high quality care.
Mosaic Employee Benefits is an insurance brokerage that has served clients since 1986. It offers a wide range of employee benefits such as retirement plans, health insurance, life insurance, and HR services. Mosaic works with many major carriers and provides customized solutions based on each client's unique needs. It also offers services like an online HR portal and wellness programs through ERC Health to improve benefits and reduce costs.
Knowledge management and business intelligence systems in the pharmaceutical industry can provide access to valuable data and insights. This information can help decision-makers make informed choices regarding drug development, clinical trials, market expansion, and resource allocation.
Enhanced Research and Development: Knowledge management systems enable efficient storage, retrieval, and sharing of scientific knowledge, research findings, and intellectual property. This facilitates collaboration among researchers, accelerates the discovery process, and promotes innovation in drug development.
Effective Drug Discovery and Targeting: Business intelligence tools can analyze vast amounts of data, such as genomic information, clinical trial results, and patient records. This enables pharmaceutical companies to identify potential drug targets, optimize drug discovery processes, and develop personalized treatments based on patient characteristics.
Regulatory Compliance: The pharma industry operates in a heavily regulated environment. Knowledge management systems can centralize regulatory information, track compliance requirements, and ensure adherence to relevant guidelines. This reduces the risk of non-compliance and facilitates regulatory audits and inspections.
Efficient Supply Chain Management: Business intelligence systems can monitor and analyze supply chain data, including inventory levels, production rates, and distribution networks. This helps streamline the supply chain, optimize inventory management, and ensure timely delivery of pharmaceutical products while minimizing costs and waste.
Real-time Market Insights: Knowledge management and business intelligence tools provide real-time access to market data, competitor analysis, and customer feedback. This empowers pharmaceutical companies to identify market trends, understand customer needs, and make data-driven marketing and sales strategies to maximize product adoption and market share.
Patient Safety and Pharmacovigilance: Knowledge management systems enable the collection, analysis, and sharing of adverse drug event data and patient safety information. This supports pharmacovigilance efforts, helps identify potential risks, and facilitates proactive measures to ensure patient safety.
Improved Collaboration and Knowledge Sharing: Knowledge management platforms facilitate collaboration among cross-functional teams, enabling seamless information sharing, best practice dissemination, and lessons learned. This fosters a culture of continuous learning and improvement within the organization.
Cost Reduction and Operational Efficiency: Business intelligence tools can analyze operational data, identify inefficiencies, and optimize processes. This leads to cost reduction, improved resource allocation, and increased operational efficiency across various functions, such as manufacturing, logistics, and sales.
Compliance with Quality Standards: Knowledge management systems assist in ensuring
ORBIS is a comprehensive global database containing information on over 50 million public and private companies worldwide. It combines data from 100+ sources into standardized report formats, allowing for searching and comparisons across different regions and industries. Coverage includes listed companies, banks, insurers, and private European firms. ORBIS also features a unique ownership database linking over 20 million parent and subsidiary relationships. Users can access reports and financials through unlimited or pay-per-view access options.
Write a 4–6-page report for a senior leader that communicates .docxjohnbbruce72945
Write a 4–6-page report for a senior leader that communicates your evaluation of current organizational or interprofessional team performance, with respect to prescribed benchmarks set forth by government laws and policies at the local, state, and federal levels. In addition, advocate for ethical action to address benchmark underperformance and explain the potential for improving the overall quality of care and performance, as reflected on a performance dashboard.
In the era of health care reform, many of the laws and policies set forth by government at the local, state, and federal levels have specific performance benchmarks related to care delivery outcomes that organizations must achieve. It is critical for organizational success that the interprofessional care team is able to understand reports and dashboards that display the metrics related to performance and compliance benchmarks.
Maintaining standards and promoting quality in modern health care are crucial, not only for the care of patients, but also for the continuing success and financial viability of health care organizations. In the era of health care reform, health care leaders must understand what quality care entails and how quality in health care connects to the standards set forth by relevant federal, state, and local laws and policies. An understanding of relevant benchmarks that result from these laws and policies, and how they relate to quality care and regulatory standards, is also vitally important.
Health care is a dynamic, complex, and heavily regulated industry. For this reason, you will be expected to constantly scan the external environment for emerging laws, new regulations, and changing industry standards. You may discover that as new policies are enacted into law, ambiguity in interpretation of various facets of the law may occur. Sometimes, new laws conflict with preexisting laws and regulations, or unexpected implementation issues arise, which may warrant further clarification from lawmakers. Adding partisan politics and social media to the mix can further complicate understanding of the process and buy-in from stakeholders.
Assessment Instructions
Note
: Your evaluation of dashboard metrics for this assessment is the foundation on which all subsequent assessments are based. Therefore, you must complete this assessment first.
Write a report for a senior leader that communicates your evaluation of current organizational or interprofessional team performance with respect to prescribed benchmarks set forth by government laws and policies at the local, state, and federal levels. In addition, advocate for ethical action to address benchmark underperformance and explain the potential for improving the overall quality of care and performance, as reflected on a performance dashboard.
Review the performance dashboard metrics, as well as relevant local, state, and federal laws and policies. Consider the metrics that are falling short of the prescribed benchmar.
The document provides information about the key parts and operation of the Health Insurance Marketplace. It defines the Marketplace and describes the main components including qualified health plans, tax credits, cost sharing reductions, and the roles of assisters. It explains the different types of Marketplaces (Federally-facilitated, State-based, Partnership), essential health benefits, plan categories and actuarial values. The document aims to educate consumers and assisters on how to use the Marketplace to find and enroll in affordable health insurance.
Supplemental and Ancillary Products on Private ExchangesCarol Harnett
Private exchanges are beginning to gain traction as an alternate way to offer employees a way to select and purchase benefits. While vendors and consultants are making progress with private health exchanges, there are still many issues to tackle when it comes to the inclusion of ancillary, supplementary and voluntary benefits.
Unprecedented transformation is reshaping our nation's healthcare delivery system. In this post- ACA environment, providers are increasingly dependent on the government as a payor. At the same time, regulators and governing bodies at the local, state and federal level determine the ever-changing rules and regulations through which providers operate. Through all of this, one thing is clear: having a well-established government relations program has never been more important to achieving a health care organization’s strategic business goals.
Given the increasing role government relations is playing in a health system’s success, leaders across the country are rethinking how they invest in, structure and staff their programs. General counsels at some health systems are very involved in these efforts, others less so. Join us to learn why you and your organization should be assessing your approach to and management of government relations. David Jarrard and Magi Curtis will share industry insights and best practices as well as hard data from a nation-wide benchmark project they recently published that looks at how hospitals and health systems are approaching government relations.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
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- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
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1. Episode I
What’s Included in
AIS’s Directory of Health Plans?
2. The Directory comes in 2 versions…
• A printed book version
• A CD database version, which comes with a free copy of the printed book
ALL the information in the book is on the CD.
The CD has the data in Excel, Access, CSV and
ASCII file formats.
The CD also has some additional data
not found in the book (more on that later).
3. Two Data Sets
The Directory includes databases on two types of
organizations —
•Health Plans
All insurance carriers, or managed care organizations, in the U.S.
that offer fully insured health plans based on a regional network.
Includes primary medical insurance only. The latest edition of the
Directory has 500 Health Plan records.
• Preferred Provider Networks
Organizations that offer primary medical networks to
self-insured plans or insurance carriers via a fee or lease
agreement. These companies do not offer insurance
products. The latest edition of the Directory has
135 Network records.
This slide presentation focuses on the Health Plan data sets only.
4. Overview of Health Plan Data Fields
Company Data:
• Company Name
• Company Address — street, city, state, zip
• Telephone Numbers — corporate business phone, automated number for
members and claims info, corporate fax number
• Company Owner — with Owner ID to link plan to other subsidiaries of the same
parent company
• Company URL
• Profit Status of Company
• Private/Public Status of Company
• Stock Symbol
• State Service Area (states in which company operates)
• Contracted Pharmacy Benefit Manager(s)
• Aliases — a list of subsidiaries, product names, former names and other names by
which this organization may be known in various markets
• Publication Notes — additional information about the company (e.g., recent
mergers, name changes) or about the enrollment data in the record
5. Overview of Health Plan Data Fields
Key Executives
Up to 17 names per company — First Name, Last Name — Listed by Job Function
• CEO
• President
• Operations Executive
• Finance Executive
• Medical Executive
• Legal Executive
• Provider Relations Executive
• Marketing Executive
• Member Relations Executive
• Pharmacy Executive
• Specialty Pharmacy Executive
• Public Relations Executive
• Information Systems Executive
• Purchasing Executive
• Claims Management Executive
• Reimbursement Executive
• Disease Management/Wellness Executive
6. Overview of Health Plan Data Fields
Key Executives
Up to 17 names per company — First Name, Last Name — Listed by Job Function
• The CD offers complete mailing lists, with phone numbers, in convenient Excel,
Access, CSV and ASCII formats.
• Data can be imported into your sales force software.
• Your purchase of the CD entitles you to unlimited use of these mailing lists.
• Names are collected/verified by AIS editorial staff with knowledge
of each health plan’s structure and organization,
job functions, etc.
• Mailing lists include the MCO ID
field —a unique identifier
that links each executive
with the full company
record. So you can sort
and filter the names by
geography, type of plan
model, membership,
job function, etc.
7. Overview of Health Plan Data Fields
Enrollment Data (aka Membership or Covered Lives)
We count members enrolled in primary medical products only — not specialty
benefits like pharmacy, vision, dental, etc.
Starting with:
Total Medical Enrollment — the total
number of members in medical plans (risk and
non-risk) nationally, for the whole company
Total Medical Enrollment is then broken
down into 2 main categories:
•Fully Funded (Risk-Based)
•Self-Funded (ASO)
Which are further broken down…
8. Overview of Health Plan Data Fields
Enrollment Data (aka Membership or Covered Lives)
Members enrolled in primary medical products only — not specialty benefits like
pharmacy, vision, dental, etc.
This is how enrollment is broken down into subsets:
• Total Fully Funded (Risk) Enrollment • Total Self-Insured (Non-Risk/ASO)
• Total Commercial Risk Enrollment Enrollment
• HMO • Total Commercial Non-Risk Enrollment
• POS
• PPO
• Total Public Sector Non-Risk Enrollment
• FFS/indemnity
• Medicare Supplement (Medigap)
• Total Public Sector Risk Enrollment Also provided:
• Medicare Enrollment (Part C) Number of lives in Individual
• Medicare (coordinated care) (non-Group) plans and,
• Medicare PFFS
• PACE Program Enrollment specific to each
• Medicaid HMO State, plus DC and Puerto Rico
• Medicaid FFS (state agencies)
• SCHIP/other local enrollment
9. Overview of Health Plan Data Fields
Enrollment Data (aka Membership or Covered Lives)
Members enrolled in primary medical products only — not specialty benefits like
pharmacy, vision, dental, etc.
This is what it looks like in the book:
10. Overview of Health Plan Data Fields
Health Plan Enrollment fields and definitions of health plan
models can be confusing
11. Overview of Health Plan Data Fields
Health Plan Enrollment fields and definitions of health plan
models can be confusing
• AIS offers full support to make sure you understand the data accurately and use
it appropriately for your specific projects.
• AIS’s Directory of Health Plans provides thorough explanations of each type of
enrollment in the Introduction section of the book (also in PDF on the CD).
• Our knowledgeable editorial staff is available to answer any
questions this material doesn’t cover.
12. Highlights and Analysis of the
Health Plan Industry
Highlights — Chapter 1 offers many tables, charts and calculations that
have been performed for you by AIS editorial staff, to answer such questions as:
Which health insurer is the largest by membership?
Where does my insurer rank by enrollment?
Who has the largest Medicare membership?
Which are the top 10 companies by HMO enrollment?
What % of U.S. covered lives are enrolled in for-profit plans?
Individual (non-group) plans? Risk-based plans? POS plans?
Non-risk (ASO) plans? Public-sector plans? Medicaid HMOs?
Commercial PPOs? Publicly traded corporations…
AIS’s Directory of Health Plans is the foremost authority on health plan enrollment statistics
13. Special Features of the CD Version
The CD version of AIS’s Directory of Health Plans
offers many special features and capabilities:
• Electronic files allow you to sort, filter and export the data for
your specific purposes
• A PDF version of the book allows for fast keyword searching
• You get a free copy of the paper book, so you’re not giving up
anything
Free
Copy!
14. Special Features of the CD Version
Files are in regular Windows formats — no special
software to learn
15. Special Features of the CD Version
Spreadsheets Developed for the CD Only
Subsidiary Addendum Excel workbook with:
•Worksheets featuring enrollment details for 20 large national companies with multi-
state service areas
•Lines for distinct subsidiaries/units by state, with enrollment breakdowns by type of
product
16. Special Features of the CD Version
Spreadsheets Developed for the CD Only
Subsidiary Addendum Excel workbook with:
•Worksheets featuring enrollment details for 20 large national companies with multi-
state service areas
•Lines for distinct subsidiaries/units by state, with enrollment breakdowns by type of
product
Parent Organizations
spreadsheet with:
•Total enrollment, by
product type, for all
subsidiaries
•Corporate address, phone
and CEO for 39 large
national organizations
17. Special Features of the CD Version
Spreadsheets Developed for the CD Only (continued)
• Convenient mailing lists
• Total enrollment by company by state
• Enrollment breakdowns, rolled up by parent organization
Spreadsheets for specific market sectors:
•Breakdowns by company, by state, of commercial enrollment only
•Breakdowns by company, by state, of Medicare Advantage enrollment only
•Breakdowns by company, by state, of Medicaid HMO enrollment only
•Breakdowns by company, by state, of FFS Medicaid enrollment only
•All of the above enrollment types, broken down by company, by state
Additional Data Fields Included on the CD Only
• Checkbox indicating whether a company is a Blue Cross and Blue Shield affiliate
• Total number of physicians (PCPs) and hospitals (acute-care) in health plan
networks
18. Methodology
All known health insurers and PPO networks operating
as of Jan. 1 believed to fit the criteria of the database are
Q: How Can AIS Get
included. Inclusion is not optional. Companies are surveyed
Such Comprehensive
by AIS staff between Oct. 1 and Dec. 31 of the year preceding
Participation from
the date of the Directory. AIS researchers are specially trained
Health Plans?
to understand enrollment terminology and how membership
is counted by plans.
Each organization is contacted and offered options to fill out A: As the publishers of Health
an online or paper form, or to provide data via email, fax, mail Plan Week, and many other
or via telephone interview. Information provided directly by long-running, highly respected
companies is deemed the most accurate and up-to-date industry publications, AIS has
information. For companies that do not return a survey, or established relationships with
where blanks are left on responses, researchers endeavor to all the major health insurers.
complete the record through other means. Survey data is
audited against public records as available. Additionally, AIS’s Directory of
Health Plans is an official
Fully insured commercial HMO enrollment is audited against directory resource of America’s
state insurance department filings. Medicare enrollment is Health Insurance Plans (AHIP),
audited against Centers for Medicare and Medicaid Services the trade association
(CMS) records. Medicaid enrollment is verified with state representing health insurance
Medicaid agencies. Records are supplemented by data from companies.
company websites, SEC filings, press releases and news
reports.
AIS’s Directory of Health Plans is the foremost authority on health plan enrollment statistics
19. What Other Health Plan Data Does AIS Have?
Employer Health Plan Data
AIS’s Employer Health Plan Database and Directories
provides valuable competitive intelligence on
employers; their health insurance carriers, brokers and
TPAs; plan designs; markets; fees and charges; claims;
and membership. Based on ERISA 5500 filings, records
link to AIS’s Directory of Health Plans records via MCO
ID.
Expand your knowledge of health plans’ commercial
client base.
http://aishealth.com/marketplace/aiss-employer-health-plan-database-and-directories
20. Ready to Order
AIS’s Directory of Health Plans?
Order Via Our Website at http://
aishealth.com/marketplace/aiss-directory-health-plans
Or call Customer Service at (800) 521-4323
Still Have Questions?
Our Customer Service Representatives will gladly put you in touch with our
technical editors to make sure you have a full understanding of the database and
how to apply it to your specific projects. Call us!
•View Episode 2 for more information about how to use the Directory to research
details about insurance companies.
•View Episode 3 if you don’t know whether to purchase the book OR the CD.
•View Episode 4 for more information about using the contact data and mailing
lists.