Consolidation Among Managed Care Organizations Seen Heating Up; Aetna and Cigna Licking Their Chops

There has been a wave of mergers and acquisitions in the health insurer marketplace in recent years, our research for the National Directory of Managed Care Organizations has found.

The numbers of MCOs keeps shrinking, according to our research for the database.

Just the other day Humana announced that it was working with advisers at Goldman Sachs Group Inc., according to people familiar with the matter, the Wall Street Journal reported. “Aetna Inc. and Cigna Corp. are among those that have held preliminary discussions with the company,” the WSJ reported.

“We view this step as a trigger event in a managed-care industry overdue for consolidation, the   “analysts at Leerink Partners LLC wrote in a research note Friday afternoon, The WSJ reported.. “We expect the next year will see multiple strategic actions among the major players.”

“It’s sale may trigger consolidation that shrinks the number of large publicly traded health insurers from five down to three, said analyst Ana Gupte, PhD, Leerink’s Managing Director for Healthcare Services.. “It’s a huge push for scale,” she added.

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The National Directory of Managed Care Organizations Database

This unique database provides managed care market business
intelligence on more than 1180 managed care organizations
that offer 5,279 health insurance plan products.

This managed care directory also covers specialty HMOs and PPOs,
and includes details on PBMs, TPAs, PSOs, POSs, EPOs, Medicare,
Medicaid Plans, and Medicare Advantage Health plans.

The National Directory of Managed Care Organizations Database

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Executives from Aetna and Anthem Inc. have said in recent weeks they are interested in doing large deals, Reuters reported. Analysts said on Friday that Anthem may also look at Humana.

“The government has pressured health insurers to cut costs with the new Obamacare exchange plans and in Medicare while employers have also gotten tough on spending for medical procedures and drugs,” reported Reuters.

“Acquiring Humana would vault Cigna to the lead in the market for Medicare Advantage policies, Continue reading

Health Plan Member Satisfaction in 2014

Issues surrounding the time a member must wait after a pre-approval request has been submitted to their health plan before they hear from their provider, to concerns about having adequate health coverage, and health plan notices of changes in their coverage, networks or rates are having an impact on members satisfaction with their plan, found a recent study.

Some 41 percent of existing health plan members believe that they lack enough coverage for routine visits, serious illness or injury, health and wellness programs, routine diagnostics and drug coverage, found the study by market research firm J.D. Power.

Concerns over not having enough health coverage negatively impacts overall satisfaction by 133 points, more than any other coverage-related issue, according to the J.D. Power 2014 Member Health Plan StudySM.

The study, in its eight year, measures satisfaction among members of 136 health plans in 18 regions throughout the United States by examining six key factors: coverage and benefits; provider choice; information and communication; claims processing; cost; and customer service.

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The National Directory of Managed Care
Organizations Database for Your State

Need a list of health plans just for the state that you are in?
You do not need to buy an entire directory of managed care or list of HMOs
for the whole country when you only need to know about the health plans in your state.
And its affordable.
Find out more: National Directory of Managed Care Organizations Database for Your State
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In 2014, overall member satisfaction averages 669 (on a 1,000-point scale), the firm said.

Key Findings include:   Continue reading

News Release – 2014 National Directory of Managed Care Organizations Database Produced

News Release

For Immediate Release

New Edition of Database Provides Overview, Details and Managed Care Market Key Decision Makers

Phone: 1- 800-516-4343

ALLENWOOD, NJ – The 2014 edition of the National Directory of Managed Care Organizations has been published by the Managed Care Information Center.

As in other industries – there has been consolidation in the managed care organization arena as well, Managed Care Information research has found.

Research on the 2014 edition of the National Directory of Manaaged Care Organizatyions project results reflects the various health plan consolidations – mergers and acquisitions.

The unique database provides market intelligence information on more than 1180 managed care organizations representing 5,279 health insurance plans.

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, 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” detail in the managed care organization profiles presented.

Organization profiles include the health insurance companies’ main address, phone, fax, 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. The name of the parent organization, the year the organization was founded, and web site address also is provided.

The National Directory of Managed Organizations Database with user’s manual and instructions is delivered on CD-Rom.

For more information contact The Managed Care Information Center – Health Resources Online  toll-free telephone 1-800-516-4343, email: info@healthresourcesonline.com

Or click on this link: National Directory of Managed Care Organizations Database

Address: The Managed Care Information Center, PO Box 456, Allenwood, NJ 08720

Contact: 1-800-516-4343

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The 2014 edition of the National Directory of Managed Care Organizations Database is Now Available

The 2014 edition of the National Directory of Managed Care Organizations Database is now available.

We have completed a full, thorough update and verification of the database. So it is ‘squeaky clean.’

For ‘bragging’ rights we want you to know that our work is extremely detailed. We especially zeroed in on C-Suite and other senior health plan executives.

Results: 12,282 changes to the database.

There has been – as in other industries – consolidation in the managed care organization arena as well, our research has found.

The research project results reflects the various health plan consolidations – mergers and acquisitions.

The National Directory of Managed Care Organizations Database has been continually researched, verified and compiled by the Managed Care Information Center team since 1996.

The database includes hard-to-find managed care information on HMOs, PPOs, POSs, Specialty MCOs,  health plans that offer consumer driven health plans (CDHPs) and health savings accounts (HSAs) , Medicare Advantage plans, Medicaid Managed Care plans,and Medicare Part D prescription plans.

For details on the new edition of this trusted database visit: http://bit.ly/1gJFVba

 

Managed Care Information Center ‘Store’ New Web Address

Our health and managed care databases
store page has a new web address following
our migration to our new,improved web site
at healthresourcesonline.com.

The store is protected for security with “Secure Socket Layer” or SSL to keep your transactions secure.

Because there are so many links to our directory – databases and management resources up on the Web we think it is a good idea to give you the new location link:   https://www.healthresourcesonline.com/payer-provider-data.html

Three Additional MCOs Signed For State Medicaid Health Services in KY

Anthem, Humana and Passport have signed agreements with the Cabinet for Health and Family Services to provide healthcare services to state residents who will be newly eligible for coverage under the expansion of Medicaid, a provision of the Affordable Care Act.

The three new MCOs are in addition to Coventry and WellCare, which are currently serving this area, officials said.

Beginning October 1 residents in 104 Kentucky counties who are determined to be newly eligible for Medicaid will be able to choose the health plans as their healthcare provider for coverage effective Jan. 1, 2014.

“Under the terms of the contract, the three MCOs will initially serve exclusively the more than 300,000 who will be newly eligible for Medicaid,” officials said. Continue reading

Tax Credits Estimated to Average $2,700 Per Family Next Year for People Who Now Buy Their Own Insurance

Americans who currently buy their own insurance through the individual market would receive tax credits averaging nearly $2,700 next year for coverage purchased through new insurance marketplaces, found a new study.

The tax credits or subsidies would cover 32 percent of the premiums on average for this group of enrollees in a so-called “silver” plan, according to the Kaiser Family Foundation analysis. .

Foundation researchers released the analysis as some states are releasing information on what premiums will be in 2014 when the Affordable Care Act’s market reforms and newly created health insurance marketplaces take effect.

The rate announcements illustrate “sticker prices” that do not reflect federal subsidies that will offset the cost of insurance for many current individual market policy holders, said the foundation based in Menlo Park, California.

“Tax subsidies are an essential part of the equation for many people who buy insurance through the new marketplaces next year,” Foundation President and CEO Drew Altman said. “They will help make coverage more affordable for low- and middle-income people.”

Under the ACA tax credits will be available to subsidize premiums for people who buy their insurance in the new marketplaces, do not have access to other affordable coverage, and have incomes between 100 percent and 400 percent of the federal poverty level (between about $11,500 and $46,000 for a single person, and $24,000 and $94,000 for a family of four).

An estimated 48 percent of people who currently have individual market coverage will be eligible for tax credits, researchers found. Tax credits among those eligible will average $5,548 per family, and subsidies will average $2,672 across all families now purchasing their own insurance, the researchers said.

Many people who are now uninsured will also be eligible for subsidies in the new marketplaces, and their tax credits will likely be higher on average since they have lower incomes than those who now buy their own coverage, the researchers said.

Using data from the Congressional Budget Office (CBO) and the federal government’s Survey of Income and Program Participation, study authors said the analysis estimates the average impact of the ACA on the individual market by quantifying how current enrollees will fare once relevant provisions of the health law are implemented.

Premium data released by states thus far suggest that the CBO premium projection is reliable, the researchers said. While subsidies and premiums will vary widely depending on each enrollee’s personal characteristics, the analysis focuses on averages to provide an indication of how much overall assistance the law will provide to people buying their own coverage today, the study authors added.