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

Are MCOs adequately addressing member satisfaction needs?

Related to the member communication initiatives of MCOs is meeting member\patient satisfaction.

So are health plans addressing patient satisfaction as a top priority?

This is question, from our Managed Care Leadership Survey, stirs strong opinions from providers, payers and others.

For instance: “No. Major carriers are doing just enough to maintain their satisfaction levels. They are also building their own satisfaction surveys to give the impression that they are top notch. A better way would to use a consistent measure like CAHPS to monitor.”

“Yes. New rules and bonus payments”

“No. Too little in the way of real tools, peer to peer assistance”

“No. Growing limits on provider access and increased carveouts are creating growing member dissatisfaction.”

“Yes. Adequately, yes. Meeting expectations, probably not. All depends on the benchmarks one is willing to use to measure member satisfaction.”

Source: Managed Care Information Center