12-16-2009
JACKSONVILLE’S SHANDS HOSPITAL STRUGGLES AMID INCREASED CHARITY-CARE COSTS AND FUNDING CUTS
New Report from HealthLeaders-InterStudy Provides Snapshot of Jacksonville, Fla.’s Managed Care and Healthcare Environment
12-15-2009
MAJORITY OF SURVEYED PHARMACY DIRECTORS EXPECT TO COVER PFIZER’S TANEZUMAB IF APPROVED FOR THE TREATMENT OF CHRONIC PAIN
Coverage is More Inclusive as Drug Price Decreases, But Likely to Require Failure of Multiple Lines of Pharmacotherapy, According to a New Report from HealthLeaders-InterStudy and Fingertip Formulary
12-14-2009
COVERAGE OF ORALLY DELIVERED ONCOLOGY DRUGS TO SHIFT MORE COST RESPONSIBILITY TO PATIENT
However, Coinsurance Percentage on Orally Delivered Agents to Treat Hematological Cancers Likely to Decrease, According to a New Report from HealthLeaders-InterStudy and Fingertip Formulary
12-07-2009
VALUE-BASED BENEFIT DESIGN TREND GROWS AS HEALTH PLANS EXPAND OFFERING TO FULLY INSURED GROUP MARKET
Blue Cross and Blue Shield of Massachusetts Among First to Approach the Fully Insured Market with VBBD, According to a New Report from HealthLeaders-InterStudy
11-23-2009
MILWAUKEE EMPLOYERS SEE COST SAVINGS WITH HIGH-PERFORMANCE PROVIDER NETWORK
New Report from HealthLeaders-InterStudy Provides Snapshot of Milwaukee’s Managed Care and Healthcare Environment
11-19-2009
MEDICAID ENROLLMENT GREW BY 2 MILLION LIVES IN THE FIRST HALF OF 2009
Florida, Michigan Among States with Greatest Medicaid Enrollment Increases, According to New Data from HealthLeaders-InterStudy
11-12-2009
AETNA AND UNITEDHEALTHCARE COMPETE FOR COLLEGE STUDENT MARKET
Plan Designs Typically Limit Prescription Drugs, According to New Report from HealthLeaders-InterStudy
11-05-2009
NEW COMMERCIAL PPO IN CALIFORNIA BUILT ON VALUE-BASED INSURANCE MODEL
New Full Service PPO Strategy in Line with National Trend Toward Value-Based Initiatives, According to New Report from HealthLeaders-InterStudy
11-04-2009
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS’ ALTERNATIVE QUALITY CONTRACT OFFERS NEW CONTRACTING DESIGN
New Report from HealthLeaders-InterStudy Provides Snapshot of Massachusetts’ Managed Care and Healthcare Environment
10-13-2009
RECENTLY APPROVED ONGLYZA IS COVERED BY 44 PERCENT OF COMMERCIAL HEALTH PLANS
Drug Most Likely to Be Covered as a Tier 3 Benefit, But Internal Review Likely Within Six Months, According to a New Report from HealthLeaders-InterStudy and Fingertip Formulary
09-09-2009
MOST SURVEYED MCOS INTEND TO COVER AMGEN’S PROLIA FOR OSTEOPOROSIS WHEN IT IS LAUNCHED IN THE U.S.,
Price Will Not Substantially Alter Prolia’s Tiering Status but Will Affect Availability, According to a New Report from HealthLeaders-InterStudy and Fingertip Formulary
08-25-2009
CONSOLIDATION AMONG CHICAGO PHYSICIANS LIKELY TO INCREASE
Hospitals Eager to Employ Physicians to Grow Referral Streams and Boost Leverage with Health Plans, According to New Report from HealthLeaders-InterStudy
08-19-2009
MIAMI-AREA EXPERIENCED FEWER FLUCTUATIONS IN PHARMACY BENEFIT ENROLLMENT THAN OTHER FLORIDA MARKETS
Medical Benefit Enrollment Grew Nearly Three Percent Despite Rising Unemployment Rate, According to Data from HealthLeaders-InterStudy
08-12-2009
NEW CONTRACT AWARDS MAY SHIFT THOUSANDS OF MEDICAID ENROLLEES IN MICHIGAN
Win May Increase Health Plan of Michigan’s Regional Influence, According to New Report from HealthLeaders-InterStudy
08-06-2009
U.S. PAYERS INTEND TO LIMIT PREFERRED COVERAGE TO ONLY ONE IMMUNE BIOLOGIC
Therapeutic Area Tenders May Help Some Brands Remain Competitive with Remicade and Humira, According to a New Report from HealthLeaders-InterStudy and
Fingertip Formulary
07-28-2009
MEDIGAP PLANS IN ILLINOIS TO BENEFIT FROM MEDICARE ADVANTAGE REIMBURSEMENT CUTS
Blue Cross Blue Shield of Illinois Among Managed Care Organizations to Benefit From Potential Shift to Medicare Supplement Plans, According to New Report from HealthLeaders-InterStudy
07-20-2009
L.A. HOSPITALS STRUGGLE FOR EMERGENCY ROOM CARE, PAY PHYSICIANS HIGH FEES FOR ON-CALL COVERAGE
Physicians Have Less Clout with Area Health Plans, According to New Report from HealthLeaders-InterStudy
07-16-2009
IN COLORADO, COMMERCIAL MEDICAL AND PHARMACY BENEFIT ENROLLMENT DOWN AT STATE LEVEL
However, at MSA Level, Medical Enrollment Increased While Pharmacy Enrollment Decreased, According to Data from HealthLeaders-InterStudy
07-15-2009
INTRAVENOUS IMMUNE BIOLOGICS WILL SUFFER FROM THE PENDING SHIFT IN COVERAGE FROM THE MEDICAL TO THE PHARMACY BENEFIT
Emerging Cost Control Measures Will Restrict IV Biologics In Favor of Humira and Enbrel, According to a New Report from HealthLeaders-InterStudy and Fingertip Formulary
06-23-2009
ELECTRONIC MEDICAL RECORD TECHNOLOGY UPTAKE FACES CHALLENGES
High Rate of “Deinstallation” Seen Among Physician Groups in Phoenix, According to New Report from HealthLeaders-InterStudy
06-22-2009
HEALTHLEADERS-INTERSTUDY UNVEILS ENHANCED EMPLOYER VANTAGE
Employer Vantage Provides a Snapshot of Employer Health Benefits to Help Pharmaceutical and Diagnostic Manufacturers Identify Business Opportunities
06-17-2009
COMMERCIAL MEDICAL AND PHARMACY BENEFIT ENROLLMENT DOWN IN NEW YORK
HealthLeaders-InterStudy’s Managed Market Surveyor-Rx Evaluates How Medical and Pharmacy Lives are Covered at National, State and MSA Levels
06-15-2009
HEALTHLEADERS-INTERSTUDY LAUNCHES PHARMACY BENEFIT EVALUATOR
The New Pharmacy Benefit Evaluator Analyzes Health Plan Pharmacy Benefit Structure, Spending and the Plan-PBM Relationship to Inform Managed Care Sales Strategy Development
06-09-2009
COMMERCIAL PHARMACY BENEFIT ENROLLMENT EXPERIENCING GREATER SHIFTS IN FLORIDA THAN COMMERCIAL MEDICAL BENEFIT ENROLLMENT
Customizable Survival Kit Offers One Stop for Market-Specific Managed Care Enrollment Data and Insights into Local Healthcare Market Drivers and Health Plan Trends
06-08-2009
MEDICAL HOME PILOT INITIATIVES CONTINUE TO EXPAND NATIONWIDE
Charleston, S.C. and Rochester, N.Y. Among Latest Markets with Pilot Projects Underway, According to New Reports from HealthLeaders-InterStudy
05-26-2009
RECESSION FALLOUT LEADS SAFETY-NET HOSPITALS TO CHARGE OUT-OF-COUNTY RESIDENTS FOR NON-EMERGENCY SERVICES
Market Overviews from HealthLeaders-InterStudy Analyze Healthcare Market Drivers for the Nation’s Most Dynamic Metro Areas
05-20-2009
WHILE MOST BLUE CROSS AND BLUE SHIELD-BRANDED MCOs ARE LOSING MEMBERS, BLUE SHIELD OF CALIFORNIA BUCKS THE TREND
HealthLeaders-InterStudy’s Managed Market Surveyor-Rx Evaluates How Medical and Pharmacy Lives are Covered at National, State and MSA Levels
05-04-2009
MASSACHUSETTS HEALTHCARE REFORM COST CONTAINMENT STRATEGY FEATURED IN NEW REPORT
New England States’ Enhancement of Health Coverage Programs for the Unemployed Also Highlighted in New Analysis from HealthLeaders-InterStudy
04-30-2009
PHYSICIAN-LED QUICK-CARE CLINICS PROTECT PATIENT BASE
While Physicians Compete for Patients in Many Markets, Dayton, Ohio, Physicians Fill Area Quick-Clinic Void with Kroger Partnership, According to Reports from HealthLeaders-InterStudy
04-28-2009
FIXED DOSED COMBINATION AGENTS AND NOVEL ANTIHYPERTENSIVES ARE EXPECTED TO FACE TOUGHER FORMULARY RESTRICTIONS
Longitudinal Data Trends Suggest These Agents Will Face Greater Use of Step Therapy Restrictions and Less Access on Tier 2 on Commercial Health Plans, According to a New Report from HealthLeaders-InterStudy and Fingertip Formulary
04-13-2009
ADOPTION OF CONSUMER-DRIVEN HEALTH PLANS ACCELERATED BY RECESSION
CDHP Enrollment Expected to Grow Even Faster in 2009 As Employers See Higher Premium Increases and Look for Savings, According to New Reports from HealthLeaders-InterStudy
04-06-2009
ENROLLMENT IN EMPLOYER-CONTRACTED PHARMACY BENEFIT "CARVE-OUT" INCREASED BY MORE THAN SIX MILLION LIVES
As Employers Continue Shift to Self-Insurance for Medical Benefits, Movement to Direct Contracting for Pharmacy Benefits Also Underway, According to Data from HealthLeaders-InterStudy
03-23-2009
IN TEXAS, FAVORABLE REGULATIONS FOR PHYSICIANS MAY BACKFIRE IN LIGHT OF MARKET DOWNTURN
Lower-Than-Expected Patient Volumes Seen in Houston Physician-Owned Hospitals, According to New Reports from HealthLeaders-InterStudy
03-09-2009
FLORIDA EMERGENCY ROOM COSTS INCREASED 25 PERCENT IN THE LAST YEAR AND MAY LEAD TO MORE OPPORTUNITY FOR PHARMA INDUSTRY
ER Usage Trends and Growing Uninsured Population Raise Concerns for Area Providers and Insurers, According to New Report from HealthLeaders-InterStudy
02-23-2009
REGULATIONS AGAINST BALANCE BILLING TO IMPACT ORANGE COUNTY, CALIF., PHYSICIANS’ BOTTOM LINE
Enforcement Impacts Emergency Room Physicians in Particular, According to New Report from HealthLeaders-InterStudy
02-19-2009
MEDICAID REFORM EFFORTS UNDERWAY IN LOUISIANA AND RHODE ISLAND
States Choose Different Approaches, Yet Face Hurdles in Light of Economic Downturn, According to New Reports from HealthLeaders-InterStudy
02-10-2009
HEALTHLEADERS-INTERSTUDY OFFERS DISTRICT SURVIVAL KIT TO ARM PHARMACEUTICAL SALES TEAMS WITH LOCAL-LEVEL INTELLIGENCE
Customizable Survival Kit Offers Extensive Enrollment Information and Insights into Local Market Drivers and Health Plan Trends
02-02-2009
LESS THAN TWO-THIRDS OF SURVEYED PHARMACY DIRECTORS EXPECT TO REIMBURSE BOTH ONGLYZA AND ALOGLIPTIN ONCE THEY ARE AVAILABLE
Contract Negotiation is Leading Factor in Improving Formulary Placement of Newer Entrants to Antidiabetic Market, According to a New Report from HealthLeaders-InterStudy and Fingertip Formulary
01-26-2009
HOSPITAL EXPANSIONS IN BUFFALO, N.Y., AND BATON ROUGE, LA., CONTRIBUTE TO RECESSION RESILIENCE
While Building Boom Declines in Some Regions, These Markets Remain Stable, According to New Reports from HealthLeaders-InterStudy
01-14-2009
MEDICARE ADVANTAGE MEMBERSHIP INCREASED BY ONE MILLION BETWEEN JANUARY AND JULY 2008
Enrollment in Private Fee-for-Service Plans Significantly Contributed to Growth, According to Newly Released Data from HealthLeaders-InterStudy
01-07-2009
HEALTH PLANS, EMPLOYERS TAKE CLOSER LOOK AT COSTS & EXPAND DISEASE MANAGEMENT INITIATIVES IN RESPONSE TO DIABETES PREVALENCE
Stakeholders in Tennessee, Virginia Look to Eliminate Barriers to Care, According to New Reports from HealthLeaders-InterStudy
12-22-2008
SELF-INSURED MEDICAL ENROLLMENT INCREASED BY MORE THAN 1.6 MILLION LIVES BETWEEN JANUARY 2008 AND JULY 2008
Enrollment in Consumer-Driven Health Plans Also Showed Increases, According to Newly Released Data from HealthLeaders-InterStudy
12-11-2008
EMPLOYER VANTAGE PROVIDES A SNAPSHOT OF BOTH SELF- AND FULLY-INSURED HEALTH BENEFITS TO HELP
With Thousands of Employees Covered by Plans in Multiple States, Lockheed Martin Presents Example of How Companies Can Use Employer Vantage to Identify Local-Level Opportunities
12-10-2008
ECONOMIC DOWNTURN MEANS INCREASED DEMANDS ON BUDGET-CHALLENGED STATE HEALTH COVERAGE INITIATIVES
New York and Wisconsin Among States with Hurdles Ahead, According to New Reports from HealthLeaders-InterStudy
12-08-2008
LOW REIMBURSEMENTS COMPLICATE PHYSICIAN RECRUITMENT EFFORTS IN MAINE
Physician Groups Increase Integration With Area Hospitals to Improve Reimbursements, According to New Report from HealthLeaders-InterStudy
12-04-2008
FLORIDA’S SMALL-GROUP HEALTH INSURANCE GREW IN FIRST HALF OF 2008, THOUGH ECONOMIC DOWNTURN LIKELY TO HALT UPWARD TREND
UnitedHealth Group Among Insurers Likely to Lose Enrollment, According to New Report from HealthLeaders-InterStudy
12-01-2008
OUTLOOK POSITIVE FOR MADISON, WIS., AREA HEALTH SYSTEMS
Expansion Projects, Strong Occupancy Rates and Reduction in Uninsured Population Are Contributing Factors, According to New Report from HealthLeaders-InterStudy
11-19-2008
INSURERS EMPLOY MULTIPLE SOLUTIONS TO AVOID RADIOLOGY EXPENSE SPIKE
UnitedHealthcare Among Plans With Provider Education Programs in Place, According to New Reports from HealthLeaders-InterStudy
11-18-2008
HIGHLY CONSOLIDATED INSURER SEGMENT DRIVES ROCHESTER, N.Y., HEALTHCARE MARKET
Market Known for Collaboration Among Healthcare Stakeholders May See Increased Tension Between Health Plans and Physicians, According to New Report from
HealthLeaders-InterStudy
11-12-2008
SOUTHERN NEW JERSEY HOSPITALS THRIVING, BUT CAUTIOUS IN LIGHT OF MARKET CONDITIONS
Eight New Jersey Hospitals Have Closed in 2008, According to New Report from HealthLeaders-InterStudy
11-05-2008
CHARLESTON, S.C., MARKET INTEGRATION LIKELY TO DRIVE PHYSICIAN GROUPS TO SEEK HEALTH SYSTEM AFFILIATION
Competition for Outpatient Services Are a Leading Factor for Consolidation, According to New Report from HealthLeaders-InterStudy
11-04-2008
MINNESOTA EMPLOYERS BUCK NATIONAL TREND AND LARGELY REMAIN FULLY-INSURED
Blue Cross and Blue Shield of Minnesota Leverages Market Dynamics With New Plan Offering Three Year Rate Guarantee, According to New Report from
HealthLeaders-InterStudy
10-29-2008
CALIFORNIA INSURERS ARE BEHIND THE CURVE WITH CONSUMER-DRIVEN HEALTH PLANS
Insurers Still Seeking Right Price for Consumer-Driven Products,
According to New Report from HealthLeaders-InterStudy
10-28-2008
TOP 25 MANAGED CARE ORGANIZATIONS LEAD INCREASES IN MANAGED CARE MEDICAID ENROLLMENT NATIONALLY,
Independence Blue Cross and Aetna Experienced Greatest Increases in Medicaid Lives, According to Data from HealthLeaders-InterStudy
10-21-2008
HEALTH PLAN OF NEVADA MEDICARE ADVANTAGE PLAN OFFERS VALUE-BASED DRUG OPTION
Move Hopes To Improve Health Outcomes If More Cost-Conscious Seniors Fill Their Prescriptions, According to New Report from HealthLeaders-InterStudy
10-20-2008
FACILITY AND TECHNOLOGY UPGRADES IN STORE FOR SAN DIEGO HOSPITALS DESPITE ECONOMIC CRUNCH
New Tool to Assess Earthquake Risk May Yield Significant Savings, According to New Report from HealthLeaders-InterStudy
10-16-2008
MEDICAID MANAGED CARE PROGRAM IN OHIO CONTINUES TO FACE CHALLENGES
Weak Reimbursement and High Medical Costs Have Driven Insurers From Program and Burdened Hospitals, According to New Report from HealthLeaders-InterStudy
10-14-2008
HEALTHLEADERS-INTERSTUDY LAUNCHES EMPLOYER VANTAGE
The New Employer Vantage Provides a Snapshot of Employer Health Benefits to Help Pharmaceutical and Diagnostic Manufacturers Identify Business Opportunities
10-14-2008
STATE HEALTHCARE REFORM BRINGS GROWTH TO SPRINGFIELD, MASS., HOSPITAL SEGMENT
Increased Insured Population Requires Hospital Adjustments, According to New Report from HealthLeaders-InterStudy
10-06-2008
FRAGMENTED PHYSICIAN POPULATION AND HIGHLY COMPETITIVE HEALTH SYSTEMS DEFINE COLUMBIA, S.C., MSA
Health System Competition for Physician Affiliation Offsets Physician Challenges with Insurers, According to New Report from HealthLeaders-InterStudy
09-30-2008
HOSPITAL CONSOLIDATION LIKELY FOR CHICAGO MARKET
Acquisitions Present Best Opportunity for Area Hospital Growth,
According to Report from HealthLeaders-InterStudy
09-29-2008
PROVIDER-OWNED HMOs IN MADISON, WIS., BUCK NATIONAL TREND
Madison Area Is Among the Most Dominant for HMOs in the Country, According to New Report from HealthLeaders-InterStudy
09-23-2008
HORIZON BLUE’S CONVERSION TO FOR-PROFIT STATUS MAY ALTER PLAN’S EXISTING PRICING STRATEGY
Move May Also Help to Fund Universal Health Coverage in New Jersey, According to Report from HealthLeaders-InterStudy
09-15-2008
NATIONAL COMMERCIAL MANAGED CARE ENROLLMENT CONTINUES SHIFT FROM HMO TO PPO BUSINESS LINES
Aetna is Among National Plans Following the Trend Demonstrating 9.8 Percent PPO Enrollment Growth, According to Data from HealthLeaders-InterStudy
09-10-2008
END OF PRIVATE FEE-FOR-SERVICE MEDICARE PLANS CREATES SIGNIFICANT COMPETITION IN TRISTATE AREA
Health Plans Building Networks and Offering New Products, According to New Report from HealthLeaders-InterStudy
09-09-2008
COMPETING COLORADO SPRINGS HEALTH SYSTEMS LOOK TO NORTHERN EXPANSION
Move Will Align Hospitals with Well-Insured Population, According to New Report from HealthLeaders-InterStudy
09-04-2008
OREGON EDUCATORS BENEFIT BOARD CREATES FIRST SINGLE INSURANCE PURCHASING POOL FOLLOWING STATE MANDATE
Effort May Receive Scrutiny from Public Agencies Nationwide, According to New Report from HealthLeaders-InterStudy
09-03-2008
GROWING UNINSURED POPULATION BRINGS CHALLENGES TO CAPE CORAL-FORT MYERS, FLORIDA MARKET
Limited Access to Quick-Care Clinics and Physician Shortage Adds to Area Burden, According to New Report from HealthLeaders-InterStudy
08-26-2008
TUFTS HEALTH PLAN LOOKS TOWARD RHODE ISLAND FOR EXPANSION
Insurer Filed Application and Network Negotiations in Progress, According to New Report from HealthLeaders-InterStudy
08-20-2008
PPO REGULATION MAY SOON BE A REALITY IN TEXAS
Recommendations in Place to Provide the Texas Department of Insurance with PPO Oversight, According to New Report from HealthLeaders-InterStudy
08-13-2008
MID-ATLANTIC REGION’S CAREFIRST BLUECROSS BLUESHIELD FINDS SUCCESS IN SMALL/MID-SIZE AND SELF-INSURED MARKETS
CareFirst Continues to Grow Despite Heavy Regulatory Environment, According to a New Report from HealthLeaders-InterStudy
08-11-2008
PENDING PURCHASE OF AILING SPOKANE, WASH. HOSPITAL SYSTEM COULD RESULT IN A MORE COMPETITIVE MARKET
Expansion of Services and Better Affiliations with Physicians in Store for Empire Health Services, According to New Report from HealthLeaders-InterStudy
08-06-2008
CALIFORNIA HEALTH PLANS PREPARING FOR LANGUAGE ASSISTANCE REGULATION
After Years of Delays, Californians With Limited English-Speaking Skills Will Soon Receive Translation Services, According to a New Report from HealthLeaders-InterStudy
08-05-2008
INSURANCE GIANT LEVERAGES TECHNOLOGY TO ENHANCE OFFERINGS
Health Care Service Corporation’s Technology Investments Streamline Processes, According to a New Report from HealthLeaders-InterStudy
08-04-2008
WILMINGTON, DEL.-AREA HOSPITALS TURN TO EXPANSIONS AND IMPROVEMENTS TO KEEP PATIENTS CLOSER TO HOME
New Technology, Cancer-Care Facilities and Research Opportunities Help Area Providers Compete with Larger Markets, According to New Report from HealthLeaders-InterStudy
07-31-2008
TENNESSEE INSURER COPES WITH RISING SPECIALTY DRUG COSTS
BlueCross BlueShield of Tennessee Utilizes Higher Tier Levels and Increased Copays for Specialty Drugs, According to a New Report from HealthLeaders-InterStudy
07-30-2008
GOV. RICHARDSON’S HEALTHCARE REFORM AGENDA GAINS NEW LIFE
Budget Surplus in New Mexico Provides Additional Opportunity for
Universal Health Coverage Proposal but Obstacles Remain, According to a New Report from HealthLeaders-InterStudy
07-29-2008
REGENCE GROUP’S OREGON AND WASHINGTON BLUE PLANS ARE WELL POSITIONED FOR SUCCESS IN LOCAL MEDICARE MARKET
Medicare PPO Strategy Sets Regence Blue Plans in Oregon and Washington Apart, According to a New Report from HealthLeaders-InterStudy
07-23-2008
NEW YORK TAKES STEPS TO BRING HEALTHCARE COVERAGE TO MORE RESIDENTS
Expansion of Child and Family Health Plus Programs Reach Out to Uninsured, According to New Report from HealthLeaders-InterStudy
07-21-2008
NEW YORK’S EXCELLUS BLUECROSS BLUESHIELD TO CONTINUE GENERIC MEDICATION PROMOTION TO HELP CONTROL COSTS
The Blue Plan Experienced a 15 Percent Increase in Prescription Drug Costs in 2007, According to a New Report from HealthLeaders-InterStudy
07-15-2008
FRAGMENTED LOS ANGELES HOSPITAL MARKET PROVIDES HEALTH SYSTEMS WITH LITTLE LEVERAGE TO NEGOTIATE HIGHER REIMBURSEMENT
Large Number of Hospitals Operating in the Red Compounds Financial Problems, According to New Report from HealthLeaders-InterStudy
07-08-2008
BLUE CROSS BLUE SHIELD OF MICHIGAN’S PROPOSED REFORMS MAKE LITTLE PROGRESS WITH STATE SENATE
Approved Compromise Measure Provides Consumer-Friendly Reform to Individual Health Plan Market, According to a New Report from HealthLeaders-InterStudy
06-24-2008
POTENTIAL BLUES MERGER POSES CONCERN FOR AREA HEALTH SYSTEMS
Hospital Consolidation and New Affiliations Likely As Market Prepares For Health Plan Merger, According To New Report from HealthLeaders-InterStudy
06-04-2008
ILLINOIS INSURERS TURN TO VALUE-BASED PHARMACY DESIGN AS NEW COST SAVING MEASURE
Health Alliance Medical Plans Expands Formulary System to Fully-Insured Employers, According to a New Report from HealthLeaders-InterStudy
05-15-2008
BLUE CROSS BLUE SHIELD OF MICHIGAN BATTLES SLUGGISH ECONOMY WITH DIVERSE PRODUCT LINEUP
Medicare Advantage Fee-For-Service Plan Positions Blue Cross Blue Shield of Michigan to Win New Business, According to a New Report from HealthLeaders-InterStudy
05-14-2008
SPARED FROM REPORTING A NET LOSS, HIGHMARK FINDS OPPORTUNITY IN DIVERSIFICATION
Highmark Faces Increasing Competition from National Insurers in Pennsylvania, According to a New Report from HealthLeaders-InterStudy
04-29-2008
MAJOR DALLAS HEALTH SYSTEMS IMPLEMENT QUALITY INITIATIVES TO ENHANCE CLINICAL PERFORMANCE
New Executives Drive Clinical, Quality & Process Improvements, According to New Report from HealthLeaders-InterStudy
04-16-2008
BLUE CROSS BLUE SHIELD OF NORTH CAROLINA IMPLEMENTS AGGRESSIVE GENERIC MEDICATION CAMPAIGN
The Plan Moves More than 40 Tier 3 Drugs for Chronic Diseases to Tier 2, According to a New Report from HealthLeaders-InterStudy
04-09-2008
MIAMI HOSPITAL MARKET SEES SHIFT IN OWNERSHIP OF TWO AREA FACILITIES
For-Profit HCA and Tenet Healthcare Each Sell Financially Challenged Facilities to Local Market Players, According to New Report from HealthLeaders-InterStudy
04-08-2008
PENNSYLVANIA HEALTH PLANS EMPLOY VARIOUS STRATEGIES TO COMBAT COST OF SPECIALTY DRUGS
With No Generic Alternatives For Specialty Drugs, Insurers Try Intensive Cost-management Measures, According to a New Report from HealthLeaders-InterStudy
03-25-2008
WITH THE END OF STEERAGE, TOLEDO, OHIO CONSUMERS GIVEN CHOICE OF HEALTH SYSTEMS FOR CARE
Open Market Provides Opportunities for Cost Containment and Introduction of Consumer-Driven Care, According to New Report from HealthLeaders-InterStudy
03-17-2008
POPULATION GROWTH IN SMALL FLORIDA MARKETS POSES OPPORTUNITY FOR HEALTH PLANS
Health Plan Market Becomes More Competitive as Local and National Insurers Target Growing Communities, According to a New Report from HealthLeaders-InterStudy
03-04-2008
PROGRAMS TO TACKLE RISING HEALTH INSURANCE PREMIUMS SAN ANTONIO EMPLOYERS LOOK TO WELLNESS
Humana and Local Brokerage Firm Offer Innovative Programs to
Gain Members, According to New Report from HealthLeaders-InterStudy
02-27-2008
MERGERS AND NEW FACILITIES ABOUND IN WASHINGTON, D.C. SUBURBS
Growing Number of Wealthy Suburbanites Equal High Demand for
Medical Services, According to New Report from HealthLeaders-InterStudy
02-04-2008
CONSUMER DRIVEN HEALTHCARE CONTINUES TO MAKE ITS MARK ON INDIANAPOLIS MARKET
Stakeholders Count On New Initiatives in the Push Toward Consumerism, According to New Report from HealthLeaders-InterStudy
01-21-2008
STRUGGLING MEDICAL DELIVERY SYSTEM IMPACTS HOSPITALS AND PHYSICIANS HARDEST
Financial Problems Stem From Increased Labor Costs and Upswing in Uninsured Patients, According to New Report from HealthLeaders-InterStudy
01-07-2008
SOUTH CAROLINA MEDICAID PROGRAM INJECTED WITH NEW LIFE AS INSURERS VIE FOR MEMBERS
National & Local Health Plans See Opportunity with the State’s Newly Reformed Program, According to a New Report from HealthLeaders-InterStudy
12-19-2007
BOOSTS IN MANAGED CARE ENROLLMENT SEEN ACROSS THE BOARD
Managed care enrollment from January 2007 to July 2007 has seen significant shifts across the board, including growth at the plan, product and geographic levels. The details of this membership growth, from Medicare and PPOs to national and local health plans, is revealed in the new release of Managed Market Surveyor, a healthcare market intelligence product that examines the details of health plan enrollment growth.
12-18-2007
INITIATIVES TARGET LOWERING DRUG UTILIZATION FOR TENNESSEE RESIDENTS
Tennessee may have the highest drug utilization rate in the country, but initiatives within the state are working to push the state off this top spot.
12-12-2007
MARYLAND EXPANDS MEDICAID TO REACH UNINSURED
Maryland's Medicaid managed care organizations stand to gain as many as 100,000 additional members as a result of the state's newly enacted healthcare law.
12-12-2007
WORCESTER HOSPITALS STRENGTHEN TIES TO BOSTON-AREA HEALTH SYSTEMS
The regional dominance of UMass Memorial Health Care has pushed its competitors into partnerships with Boston hospitals.
12-06-2007
MICHIGAN HEALTH PLANS CONTINUE FOCUS ON GENERICS FOR COST SAVINGS
Michigan’s largest health insurers are making it more difficult for pharmaceutical companies to move their name brand medications; local insurers tout a higher than average generic utilization, maintain low generic copays and have been innovative in new programs to further promote generic usage.
12-03-2007
NEW MEDICAL SCHOOL AND CHILDREN’S HOSPITAL BOOSTS EL PASO, TEXAS HEALTHCARE MARKET
A four-year medical school on the campus of the Texas Tech University and a separately licensed 140-bed children's hospital at Thomason Hospital are on the horizon for the El Paso healthcare market; local officials are hoping that both facilities will serve as a beacon, attracting doctors to research, study and practice in the area for years to come.
11-28-2007
SMALL HEALTH PLANS MAKING INROADS IN FLORIDA MARKETPLACE
Smaller Florida health plans are looking to make inroads in the state’s health plan marketplace through acquisitions and stronger networks - Coventry Health Care and Great-West Healthcare are poised to move up the ranks of Florida's largest insurers, showing two successful ways to gain share in a hyper-competitive market.
11-26-2007
HORIZON BLUE CROSS BLUE SHIELD OF NEW JERSEY GOES AFTER NATIONAL COMPETITORS TO REGAIN MARKET SHARE
Horizon Blue Cross Blue Shield of New Jersey, the state's oldest and only locally based major health insurer, is on a mission recapture market share from national competitors.
11-19-2007
JACKSONVILLE POPULATION GROWTH SPURS AGGRESSIVE HEALTHCARE EXPANSION
Local Jacksonville health systems are taking advantage of market opportunities to develop medical office buildings and outpatient centers in suburban areas due to a population explosion, and closely aligned physician groups are emerging as important expansion components.
11-12-2007
MANAGED MEDICAID PILOT PROGRAM UNDER DEBATE IN ILLINOIS
Under a Senate amendment currently before the Illinois legislature, the state would create a pilot mandatory managed care program with up to three managed care companies participating; critics of the proposal are mounting a campaign to lobby legislators and keep their current primary care case management (PCCM) system intact.
11-07-2007
MEDICARE PLANS PREPARE FOR 2008 ENROLLMENT HOPING TO CAPITALIZE ON NEW MARKET DYNAMICS
Medicare plans will look toward private fee-for-service (PFFS) products and preferred provider organizations (PPOs) in the 2008 open enrollment period, looking to capitalize on new market dynamics.
11-07-2007
ROCHESTER PHYSICIANS OPPOSE NEW POLICIES OF EXCELLUS BLUECROSS BLUESHIELD
Rochester physicians will likely continue rallying against local insurance giant Excellus BlueCross BlueShield, in an attempt to thwart its power in the local marketplace; a new policy on imaging services and the insurer’s move to individual physician contracts has the local physician community on edge.
10-25-2007
ACQUISITIONS OVER TIME RESULT IN SOLID REVENUE GROWTH FOR HEALTH CARE SERVICES CORP.
While for-profit conversions of Blue Cross Blue Shield plans have stalled in recent years, the nonprofit Health Care Services Corp. (HSCS) is strongly positioned to expand its footprint by acquiring other nonprofit Blue plans.
10-24-2007
CALIFORNIA’S PAY FOR PERFORMANCE BREAKS GROUND WITH NEW PROGRAM COMPONENTS
The nation’s largest pay for performance program is breaking new ground with the addition of cost-efficiency measures and the development of a historic agreement that would allow health plans access to laboratory results exclusively held by physician groups.
09-26-2007
VIRGINIA, MARYLAND AND WASHINGTON D.C. HEALTH INSURERS SEEK TO REDUCE PHARMACY COSTS
Health insurers in Virginia, Maryland and Washington D.C. (Mid-Atlantic region) are looking to reduce pharma costs
09-19-2007
COMPANIES ARE MOVING OUT OF THEIR GEOGRAPHIC AND PRODUCT NICHES IN SEARCH OF NEW MEMBERS IN TENNESSEE
More companies are moving out of their traditional geographic and product niches in search of new members and money in Tennessee
09-12-2007
BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA IS SERIOUS ABOUT CUTTING COSTS
Blue Cross and Blue Shield of North Carolina has a number of innovative initiatives around obesity, pharmacy benefits and pay-for-performance plans that set it apart from other Blue Cross Blue Shield insurers. The focus is to cut costs.
08-28-2007
RECENT FEDERAL COURT DECISION COULD HURT EMPLOYER HEALTHCARE EXPENDITURES
A recent federal court decision involving a Suffolk County, N.Y., law could prompt re-examination of “pay-or-play” laws in other states, which require employers to spend a minimal amount on healthcare, or pay an assessment to the state
08-27-2007
DESPITE FLAT HMO MARKET, BLUE CROSS BLUE SHIELD OF FLORIDA LAUNCHES MOST SUCCESSFUL MANAGED CARE PROGRAM IN HISTORY
While Florida’s HMO market remains relatively flat, the state’s largest insurer – Blue Cross Blue Shield of Florida – has engineered one of the most successful managed care launches in history with its BlueOptions program.
07-25-2007
LARGE DYSLIPIDEMIA PREVALENT POPULATIONS IN BOSTON, CHICAGO AND NEW YORK CITY MAKE THESE MSAs ATTRACTIVE TARGETS FOR DRUG MAR
This new report that finds that the large size of the dyslipidemia prevalent population in the Boston, Chicago and New York City markets makes these metropolitan statistical areas (MSAs) attractive additional targets for overall drug market growth, despite the fact that they already have relatively high treatment rates compared with the top 50 MSAs.
07-24-2007
SHORTAGE OF PHYSICIANS IN ORLANDO PROVES COSTLY TO HOSPITALS
There is a relative scarcity of practitioners in central Florida and in the state in general. According to the latest Orlando Market Overview, the Orlando MSA falls below the national average for both physicians and primary-care physicians.
07-23-2007
PHYSICIANS CONCERNED WITH GROWING QUICK-CLINIC OPENINGS IN CHICAGO
Insurers in the Chicago area are embracing retail clinics openings, but physicians are concerned the growing quick-clinic movement may erode the physician-patient relationship. According to the latest Illinois Health Plan Analysis, retail clinics MinuteClinic and Take Care Health Centers already have a presence in the market and are working with local payers to facilitate care for patients.
07-16-2007
PROPOSED CALIFORNIA BUDGET ALLOTS $214 MILLION IN RATE INCREASES FOR MANAGED CARE PLANS IN THE MEDI-CAL PROGRAM
A new rate-setting methodology should help California Medicaid managed plans that have struggled, and in some cases lost money, in the past few years. According to the latest California Health Plan Analysis, the proposed 2007-2008 state budget allots $214 million in rate increases for managed care plans in the Medi-Cal program, the nation’s largest Medicaid program by enrollment.
07-10-2007
LOS ANGELES HOSPITALS IN MIDST OF MASSIVE BUILDING BOOM TO MEET NEWLY MANDATED SEISMIC STANDARDS
The race to meet new state mandated seismic standards for area healthcare facilities has produced a massive hospital building boom in the Los Angeles healthcare market; meeting these state mandates is an expensive proposition that some facilities cannot afford amid above-average financial losses from operations.
06-28-2007
ANTI-COMPETITIVE CONCERNS LINGER OVER PENNSYLVANIA BLUES MERGER
Concerns over the proposed consolidation of Highmark Inc. and Independence Blue Cross (IBC) continue to surface as the companies try to convince regulators and lawmakers that their proposed consolidation is in the best interest of Pennsylvanians.
06-27-2007
SOUTH CAROLINA INSURER GOES GLOBAL WITH MEDICAL TOURISM CONTRACT
BlueCross BlueShield of South Carolina is diving into the global waters of medical tourism through its new subsidiary Companion Global Healthcare, who has entered into a contract with Bumrungrad International Hospital in Thailand to assist patients who want to "go global" for medical and surgical treatment at U.S.-accredited facilities overseas.
06-25-2007
ACQUISITION AND CO-OP CONTRACT PROVIDE GROWTH FOR TWO WISCONSIN INSURERS
National Insurer Aetna and Regional Plan Dean Health Plan Are Strengthening Their Market Share In Wisconsin
06-12-2007
INOVA HEALTH SYSTEM MONOPOLY CONTINUES TO DOMINATE IN WASHINGTON D.C.
Inova Health System continues to dominate the northern Virginia hospital market, though national for-profit hospital HCA is trying to get a foothold into the area; HCA has twice won state regulatory approval to build in the area only for efforts to be halted by Inova’s court appeals.
06-11-2007
SHAKE-UP IN OMAHA HEALTH PLAN FRONT COULD CHALLENGE UNITEDHEALTH GROUP’S HMO MARKET-LEADING POSITION
There could be a shakeup on the HMO front with the pending sale of Mutual of Omaha’s group commercial business to rival Coventry Health Care, as the the combined HMOs will pose a strong challenge to UnitedHealth Group’s position as Omaha market leader.
06-06-2007
RETAIL-BASED HEALTH CLINICS’ POPULARITY GROW AS MAJOR INSURERS EMBRACE CONCEPT
The growing trend and accessibility of retail-based health clinics is emerging in communities across the country. Regardless of the stance health plans and physicians have taken on these clinics, busy consumers are responding favorably to the flexibility, low cost and convenience they offer.
06-06-2007
UNITED GUNNING FOR GROWTH IN WASHINGTON MARKET
More than two years after purchasing PacifiCare Health Systems, UnitedHealthcare is making a concerted effort to grow its membership in Washington with its consumer-directed and traditional products.
05-30-2007
FLORIDA INSURER TURNS TO RETAIL LOCATION TO REACH CUSTOMERS
Blue Cross and Blue Shield of Florida is turning to a retail location to push its insurance products in what has emerged as a growing trend in healthcare; the state's largest nonprofit insurer has opened its first retail location at a Jacksonville mall, with plans to expand the concept this year.
05-24-2007
PRIVATE FEE-FOR-SERVICE PLANS SERVE AS GROWTH ENGINE FOR MEDICARE ADVANTAGE MARKET
Health plans see private fee-for-service (PFFS) as a key method for growth in the Medicare Advantage space without having to spend money to build a network; health plans are offering PFFS products, some aggressively priced to gain a bigger piece of the market.
05-21-2007
QUALITY INITIATIVES & COST-SHARING INCREASES AS DETROIT HEALTHCARE INDUSTRY ADJUSTS TO CUTS IN THE AUTOMOBILE INDUSTRY
The local healthcare market is banking on the strong potential for quality initiatives and cost-sharing as the automobile industry’s cutbacks, layoffs and buyouts challenge health plans to hold onto market share.
05-14-2007
EMPLOYERS MOVE TO SELF-INSURED HEALTH PLANS OPTING TO BEAR THE FINANCIAL RISK THEMSELVES
There has been a surge in the number of large employers moving to self-insured health plans, opting to bear the financial risk themselves. The data detailing which employers are currently offering self-insured plans, as well as fully-insured and other health plan benefit information, is revealed in the new release of Employer Vantage, a new database product containing information on employer health benefits.
05-14-2007
MINNESOTA EYES PHARMACEUTICAL “GIFTS” TO DOCTORS
Minnesota is continuing to closely monitor relationships between the pharmaceutical industry and prescribing physicians in the state after a review of the state’s physician disclosures was detailed in a recent Journal of American Medical Association report.
05-07-2007
ILLINOIS GOVERNOR’S EXPANSION OF HEALTHCARE COVERAGE ATTEMPTS TO REACH STATE’S UNINSURED
Illinois Governor Rod Blagojevich’s plan to expand access to healthcare coverage to the state’s 1.4 million uninsured adults will be at a cost of $2.1 billion per year and proposes to fund the $60.1 billion budget with $7 billion in new business taxes.
05-01-2007
HOSPITAL SYSTEMS VIE FOR PIECE OF SEATTLE’S EASTSIDE MARKET
Seattle’s sprawl away from the Puget Sound shoreline is growing as health systems try to tap into the growing Eastside; Swedish Medical Center and Overlake Hospital Medical Center have been vying for state approval of a new hospital in Issaquah along the interstate 90 corridor.
04-24-2007
PRESCRIPTION DRUG PLAN MARKET REMAINS STABLE DESPITE NEW COMPETITORS AND VARIED PLAN FEATURES
The basic look of the prescription drug plan (PDP) market changed little with the second open enrollment period despite new competitors and variations among old plans, including increased gap coverage and lower deductibles.
04-24-2007
TEXAS INSURERS SUCH AS HUMANA & TEXAS BLUES STEP UP TO OFFER OPTIONS TO LARGE UNINSURED MARKET
While Texas lawmakers continue to wrestle with exactly what the state government might do to reduce the state’s burgeoning uninsured ranks, insurers are stepping up with products to fill the void.
04-16-2007
MIAMI-AREA HOSPITAL SALES RESULT IN NEW MARKET LEADER
A shift of market leadership positions within the Miami hospital market is as a result of hospital sales in the area; HCA East Florida Division now holds the market-leading position in terms of inpatient discharges, while previous market leader Tenet Healthcare, is tied for second with two other health systems.
04-10-2007
HOUSTON PHYSICIANS ENGAGE IN GENERAL ACUTE-CARE HOSPITAL OWNERSHIP
Houston area physicians are venturing enthusiastically into ownership of general acute-care hospitals with the vow to treat a full range of patients.
04-03-2007
UNITEDHEALTHCARE BEEFS UP NETWORK IN VIRGINIA TO BETTER COMPETE WITH CHIEF RIVAL WELLPOINT
UnitedHealth Group, the nation’s second-largest health insurer, is poised to become an even bigger competitor in the Mid-Atlantic with recent acquisitions and new contracts with three major provider systems.
03-28-2007
TENNESSEE’S STATE MEDICAID PROGRAM REDUCES PHARMACY SPENDING BY HALF
TennCare, Tennessee’s state Medicaid program, experienced a reduction in overall pharmacy spending, decreasing from $2.44 billion in 2005 to $1.20 billion in 2006, by implementing drug limits, centralized management and beefing up the state’s prior authorization process.
03-21-2007
COMMUNITY RATING ISSUE DIVIDES PENNSYLVANIA INSURERS
Gov. Edward Rendell’s proposal to ban medical underwriting in Pennsylvania is reopening a rift between the state’s Blues plans and for-profit insurers; the administration’s Prescription for Pennsylvania healthcare reform package requires all health insurers to use “adjusted” community rating for small-group and individual policies.
03-19-2007
VARIOUS FACETS OF CONSUMER DRIVEN HEALTHCARE EMERGING IN SOUTHWESTERN OHIO
Southwestern Ohio has been the site of several pilot programs initiated by health plans ranging from pay-for-performance to e-prescribing to cost transparency, all in an effort to move toward the ultimate end of consumer-driven health.
03-13-2007
HUMANA’S PARTNERSHIP WITH BUSINESS HEALTH CARE GROUP OF SOUTHEASTERN WISCONSIN PROVES SUCCESSFUL
The partnership between Humana and the Business Health Care Group of Southeastern Wisconsin is touting impressive new numbers pointing to its first-year success in controlling costs and gaining members.
03-08-2007
INPATIENT FACILITY FOR BARIATRIC SURGERY UNDER WAY IN SAN ANTONIO
Local San Antonio bariatric surgeons plan on opening a 20-bed bariatric hospital, despite a decrease in approvals for the surgery by insurers. Having been named the second fattest city in the country by the February 2007 issue of Men's Fitness, local weight-loss surgeons believe they are only meeting a fraction of the need.
03-06-2007
TAMPA HOSPITALS ADDING HIGH-END FACILITIES AND SERVICES AS LOCAL HEALTH PLANS BALK AT POTENTIAL FOR REIMBURSEMENT INCREASES
Tampa’s multiyear building boom continues with more than $1 billion in healthcare construction projects in the pipeline, as the area is gaining access to leading-edge technologies and increasing patient access to high-profit medical services.
02-22-2007
RIVAL CLEVELAND HEALTH SYSTEMS EMBARK ON BILLION-DOLLAR BUILDING PLANS AMID STAGNANT POPULATION GROWTH
Extensive hospital construction plans are underway for the area’s two main and rival hospital systems – The Cleveland Clinic and University Hospitals – even as the population stagnates growth. Both health systems have announced billion-dollar-plus campaigns for new hospital facilities and expansion and renovation plans to current structures.
02-14-2007
MASSACHUSETTS LAUNCHES PHASE II OF COMMONWEALTH CARE INITIATIVE OPENING ENROLLMENT TO ANOTHER 100,000
Massachusetts is entering the next phase of its Commonwealth Care healthcare-for-all initiative, as Phase II began January 1, 2007 with enrollment for those earning up to 300 percent of the federal poverty level.
02-08-2007
COMMISSION RECOMMENDATIONS RESTRUCTURE BUFFALO HOSPITAL MARKET
The Commission on Health Care Facilities in the 21st Century has released its recommendations to restructure the state’s healthcare delivery system; the details of how to implement the changes pose a significant challenge and local hospital leaders have no guarantee of receiving the funding to make the recommended changes.
02-01-2007
BREAKING NEWS REPORT: Medicare Advantage - Only Plans Lead Part D Growth
The vast majority of Medicare beneficiaries stuck with their existing prescription drug plans during the recent 45-day open enrollment period, leaving behind a few million seniors still unaffiliated with any drug benefit, newly released data from the Centers for Medicare & Medicaid Services shows.
02-01-2007
ORANGE COUNTY PLANS FOR HOSPITAL UPGRADES AND EXPANSION TO PROVIDE ENHANCED MEDICAL OPTIONS FOR COUNTY RESIDENTS
A hospital building boom, along with upgrades and expansion of medical service offerings, may resuscitate the Orange County healthcare market; patients seeking advanced medical treatments in neighboring counties will begin to have new options from Orange County healthcare facilities.
01-31-2007
MEDICARE ADVANTAGE FLEXES MUSCLE IN FLORIDA
Florida is prime hunting ground for the 40 companies offering Medicare Advantage plans in 2007; with a penetration rate among eligible seniors second in the nation at 22 percent, there is still potential for growth.
01-22-2007
CONSUMER-DRIVEN HEALTHCARE TAKING HOLD IN INDIANAPOLIS MARKET
The emphasis on consumer-driven health plans by key players in the Indianapolis healthcare market have created an environment where these plans could prove to be quite successful.
01-16-2007
MANAGED CARE OPTIONS INCREASING FOR CALIFORNIA MEDICARE RECIPIENTS
Managed care is making a comeback in the Medicare market in California’s rural, northern counties, as residents gain access to alternative plans to traditional Medicare Advantage.
01-10-2007
PROPOSAL TO COVER CALIFORNIA UNINSURED SPREADS THE PAIN
A mixed blessing awaits California health insurers if the state were to adopt Gov. Arnold Schwarzenegger’s $12 billion universal healthcare plan.
01-10-2007
UNITED HEALTHGROUP TARGETING UNINSURED MEN WITH BELAY PRODUCT
United HealthGroup is tapping into a new vein of customers with a product aimed at working, uninsured males in the 35-54 age bracket - Belay is a low-cost, high-deductible health plan being piloted in the Cleveland and Chicago markets.
01-09-2007
LAS VEGAS PHYSICIANS FACE ADDED PRESSURES IN AN OVERSTRESSED HEALTHCARE SYSTEM
Las Vegas physicians face an uphill climb in the next few years with a growing population, a high rate of uninsured and physician shortages. Physicians continue to experience the strain of an overstressed healthcare system, with the added pressures of high malpractice premiums and decreasing reimbursement rates from insurers.
01-04-2007
QUALITY HEALTHCARE DELIVERY INITIATIVES TAKE CENTER STAGE IN MINNEAPOLIS MARKET
The state of Minnesota has made great strides in promoting patient safety and quality healthcare delivery. According to the latest Minneapolis Market Overview, with new reporting standards for hospitals and pay-for-performance initiatives, quality care initiatives continue to have an impact on healthcare delivery.
12-28-2006
LOUISIANA HEALTHCARE REFORM PROPOSAL OUTLINES PATH TO HEALTHCARE RECOVERY IN NEW ORLEANS MARKET
One year after Hurricane Katrina, the outlines of healthcare recovery are finally emerging for New Orleans residents and stakeholders alike. Governor Kathleen Blanco’s recent proposal for redesigning the state’s healthcare delivery and financing recently submitted to the federal Department of Health and Human Services is the foundation to starting over in this healthcare market.
12-07-2006
SIERRA HEALTH SERVICES EXTENDS NATIONAL REACH WHILE FOCUSING ON IN-STATE GROWTH
Sierra Health Services is extending its national reach by offering a new private-fee-for-service Medicare Advantage plan and increasing its stand-alone Part D plan from 10 states in 2006 to 30 in the coming year. Locally, the insurer will be continue to draw members into its popular Medicare Advantage HMO, Senior Dimensions.
12-01-2006
PART D PROFITS EMERGING AT YEAR-END
After less than a year of selling stand-alone Part D plans, the nation's largest publicly held health plans say that segment of their businesses is generating profits or will do so over the next few months.
11-30-2006
CIGNA HEALTHCARE OFFERS NOT-SO-LIMITED BENEFITS PLAN TO PENNSYLVANIA WORKERS
Workers who cannot afford major medical plans, but need more coverage than a limited benefits plan are the target of CIGNA Healthcare’s Fundamental Care, a voluntary benefits plan available in Pennsylvania.
11-27-2006
MEDICARE/MEDICAID REIMBURSEMENTS CONTRIBUTE TO ALBANY HOSPITALS’ FINANCIAL HEALTH
Hospitals within the Albany metropolitan market continue to strive for profitability, but blame inadequate Medicare and Medicaid reimbursements for their prolonged struggle. Profit margins for these hospitals have improved since 2004, but not enough to generate earnings to reinvest in their operations.
11-15-2006
FINAL LAUNCH OF GEORGIA HEALTHY FAMILIES PROGRAM ENCOUNTERS FEW PROBLEMS
Georgia healthcare officials are breathing a sigh of relief that the second and final launch of the Georgia Healthy Families managed Medicaid program has so far gone off without any major hitches.
11-09-2006
PROS AND CONS: CERTIFICATE OF NEED DEBATE CONTINUES
There are two sides to every issue – a pro and a con, each laying out the rationale for thinking a certain way. When debating the issue of granting licenses for new hospitals and services, it’s the CON (certificate of need) side of the equation that determines the decision.
10-31-2006
COMMONWEALTH CARE PROGRAM LAUNCHES WITH EXPECTATION OF MORE WORK AHEAD
The most challenging aspects of the Commonwealth Care program are still ahead. As the state prepares for the launch of Phase II of the program, there is question on whether premiums are priced appropriately and how the state mandate for health coverage of all state residents will come into play.
10-25-2006
COMPETITION GROWING IN IOWA MEDICARE PART D MARKET WITH WELLMARK HOLDING ITS GROUND
The Iowa Medicare market is growing more competitive with the addition of six new providers for 2007; Iowa’s initial enrollment in Medicare Part D plans was strong and Iowans have proved to be loyal to their home-grown brands.
10-19-2006
CMS ANNOUNCES MEDICARE ADVANTAGE PLANS
The Medicare managed care plans announced by the federal government for 2007 showed little surprises, but offered a glimpse of where the industry is today and could be headed.
10-18-2006
NEW JERSEY HOSPITAL MARKET CONTINUES TO EXPERIENCE FINANCIAL HARDSHIP
Northern New Jersey hospitals continue to experience poor financial performance for a fifth consecutive year, prompting the governor to create a special commission to study the state’s healthcare resources.
10-11-2006
CONSUMER-DRIVEN HEALTHCARE CREATING NEED FOR SMART MEDICAL DEBIT CARDS
Insurers and payment processors are building technology systems to link banks, payors, providers and consumers, with the goal of developing a smart debit card that will carry all the information needed to make a healthcare purchasing transaction transparent, efficient and seamless.
10-05-2006
BLUE CROSS OF CALIFORNIA AND HOSPITAL ASSOCIATION BATTLE OVER PHYSICIAN INCENTIVE POLICY
Blue Cross of California is implementing incentives and penalties to its PPO network providers based on where certain elective procedures are performed, much to the dismay of the California Hospital Association.
10-03-2006
MEDICARE SPECIAL NEEDS PLANS FOCUSED ON CHRONIC CONDITIONS EXPAND INTO TEXAS
Texas is poised to be an explosion site for Medicare special needs plans (SNP) in 2007, as XLHealth, a Baltimore-based disease management firm, recently announced expansion into Texas through its Care Improvement Plus plan.
09-29-2006
MORE PRESCRIPTION DRUG PLANS GO NATIONAL
The number of companies offering national stand-alone prescription drug plans will nearly double next year, creating greater competition for those beneficiaries unsatisfied with their current plans and those looking to shop around for a better deal.
09-21-2006
MICHIGAN INSURERS TAP INTO INDIVIDUAL MARKET
According to the latest Michigan Health Plan Analysis, major marketing efforts are being stepped up by Michigan’s top insurers for individual health plans as a number of Michigan residents are in search of affordable, flexible insurance products.
09-20-2006
PLANNING UNDERWAY FOR COVER TENNESSEE TO ASSIST STATE’S UNINSURED POPULATION
The state of Tennessee is preparing for Cover Tennessee, a 3-part plan proposed by Governor Phil Bredesen to provide insurance coverage to the state’s uninsured population.
09-14-2006
SOUTHEASTERN WISCONSIN BUSINESS GROUP GROWS, KEEPS NARROW NETWORK OF PROVIDERS
Humana and the Business Health Care Group of Southeastern Wisconsin continue to add business to the coalition's health plan, but have rebuffed a major local hospital system that had wanted to join its select network of providers.
09-12-2006
SLOW STARTUP CASTS DOUBTS ON MEDICARE REGIONAL PPO MODEL
The highly touted regional Medicare PPOs -- billed as a way to give senior citizens throughout the country a managed care option -- are a bust, while private fee-for-service plans, which are more tailored to local areas, are soaring in popularity.
09-07-2006
CHICAGO-AREA HOSPITALS BUILD AND RENOVATE TO EXPAND SERVICES IN SUBURBAN AREAS
The Chicago healthcare market is in the process of shifting resources to make high-demand services more readily available in smaller, suburban hospitals with a building and renovation boom.
08-29-2006
ARIZONA WORKING TO REDUCE NUMBER OF UNINSURED WITH HELP TO EMPLOYEES OF SMALL BUSINESSES
Arizona is responding to its population boom with new initiatives to reduce the number of uninsured, including a proposed amendment to the state Medicaid program and new legislative efforts targeting changes that would prove favorable for the small business sector.
08-16-2006
CAROLINAS TRY CONTRASTING MEDICAID EXPERIMENTS
North Carolina’s last Medicaid HMO, Coventry-owned SouthCare, has gotten out of the Medicaid business as of August 1, meaning that the state will manage the entire Medicaid population through its own primary-care case-management (PCCM) program. South Carolina has taken the opposite approach, opening itself up to entry by competitive plans that have had success in other states.
08-09-2006
CalPERS RATE HIKES RETURN TO DOUBLE DIGITS
The California Public Employees Retirement System raised basic HMO premiums by an average 11.6 percent for 2007. This is a significant setback for the state’s largest purchaser of healthcare.
08-07-2006
STANDOFF BETWEEN HEALTHONE AND UNITEDHEALTHCARE OF COLORADO PRECURSOR OF FUTURE STRUGGLES IN DENVER’S HEALTHCARE MARKET
HealthONE and UnitedHealthcare’s recent managed care contract standoff over reimbursement rates is a sign of the competitive strength of both providers and payors in the Denver healthcare market.
08-02-2006
PPOs STILL GET THE LION’S SHARE OF THE COMMERCIAL MARKET, BUT HMOs ARE HOLDING THEIR OWN
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, just released its comprehensive Managed Market County Surveyor, giving detailed, county-level information on health plan enrollment throughout the United States for 2006.
07-19-2006
HEALTHCARE PREMIUM INCREASES MODERATE IN NEW YORK AND NEW JERSEY
Health premium increases are slowing down even in the TriState area. New York and New Jersey’s healthcare premium increases last year were in the single digits, down from double-digit increases from 2002 to 2004.
07-17-2006
RICHMOND HOSPITAL NETWORKS ADOPT DIFFERENT APPROACHES TO GROWTH
While Bon Secours Richmond Health System has focused on expanding services outside Richmond in central Virginia, Virginia Commonwealth University Health System has embarked on a plan to rejuvenate much of its downtown health center and medical campus. The first phase of VCU’s renovation, an emergency-care facility, will be complete in 2007, while the full renovation will last until 2020.
06-28-2006
HEALTHLEADERS-INTERSTUDY’S MANAGED MARKET SURVEYOR REVEALS THE SPECIFICS OF HEALTH PLAN ENROLLMENT GROWTH
North Carolina’s Blue Cross and Blue Shield plan added 180,000 members in 2005, boosting its membership to over 1 million for the first time. The details of such rapid membership growth, and which specific insurance products drove such growth, is revealed in the new release of Managed Market Surveyor, a healthcare market intelligence product that examines the details of health plan enrollment growth.
06-21-2006
KENTUCKY FIRST STATE TO REFORM MEDICAID UNDER DEFICIT REDUCTION ACT GUIDELINES
Kentucky’s new Medicaid plan, KyHealth Choices, allows for cost sharing and alternative premiums, co-pays for some services, and limits for some services and medications. Such changes would previously have required a specific waiver, but can now be implemented through a simple state plan amendment.
06-20-2006
OVERALL POSITIVE EARNINGS ALLOW HOSPITAL EXPANSION IN OMAHA
Omaha’s mostly profitable hospitals are moving into fast-growing areas. All of the three nonprofit health systems controlling the Omaha market are building facilities on the west side of Omaha, particularly along West Dodge Road; and one health system is also moving into Sarpy County, southeast of Omaha.
06-19-2006
ODS HEALTH PLANS LEADS OREGON MEDICARE ENROLLMENT
ODS Health Plans enrolled 22,800 Medicare recipients in its Medicare prescription drug product, ODS Advantage Rx, by the end of April. This gave it a 17 percent market share, while Humana Insurance and UnitedHealthcare tied with 16 percent shares.
06-12-2006
TENNCARE RFP SEEKS MIDDLE TENNESSEE MCO
The TennCare RFP for Middle Tennessee reflects the priorities of the reformed TennCare, including a return to MCO risk, strict benefit limits for adults, integration of behavioral health care, and greater disease management. The new bid process also marks the first time that TennCare contracting has been competitive and not simply open to all companies wishing to participate.
06-06-2006
NATIONAL HEALTH PLANS MOVE INTO NEVADA’S GROWING HEALTH INSURANCE MARKET
Despite the state’s rapid population growth, national health insurance plans face a challenge in taking any market share from local plans like Sierra Health Services, Inc. Other HMOs are avoiding direct competition with Sierra, especially in the Las Vegas area, and are looking to the self-insured market for their immediate growth.
05-31-2006
UNITED EYES PENNSYLVANIA AS NEXT TARGET FOR HEALTH PLAN MEMBERSHIP GROWTH
National insurance giant UnitedHealthCare has tagged Pennsylvania as a major growth market, and is moving aggressively to establish a greater presence there. United regards Pennsylvania as among its best growth opportunities nationally.
05-30-2006
RIVERSIDE-SAN BERNARDINO HEALTH SYSTEMS PLANNING MAJOR HOSPITAL EXPANSIONS
Several of the 35 hospitals in the Riverside-San Bernardino area are planning costly construction and expansion projects. Projects in the pipeline include three for-profit and two nonprofit hospitals, expanded emergency rooms, cardiology facilities, and medical office buildings.
05-22-2006
DRIVEN BY POPULATION GROWTH, TUCSON HEALTH SYSTEMS PLANNING MAJOR HOSPITAL EXPANSIONS
All three of Tucson’s largest non-profit hospital systems have significant expansion plans under way. The rapidly expanding population means enough new patient volume to go around, so the systems can grow market share without directly competing.
05-17-2006
MINNESOTA HEALTH PLANS DOING WELL DESPITE 2005 OPERATING LOSS
Minnesota’s major non-profits health plans experienced an overall operating loss of $78.5 million in 2005.
05-10-2006
LOCAL HEALTHCARE QUALITY-IMPROVEMENT EFFORTS FOCUS ATTENTION ON DES MOINES PHYSICIANS
National attention is focused on the Des Moines healthcare market due to industry-leading efforts by local physicians at implementing several healthcare quality-improvement initiatives.
05-09-2006
DESPITE POOR LOCAL ECONOMY, DETROIT HOSPITALS IN THE MIDST OF A $1 BILLION CONSTRUCTION BOOM
Detroit-area hospitals have decided to assume serious financial risk by constructing expensive facilities despite slim positive operating margins.
05-08-2006
MASSACHUSETTS TO RANK AND TIER PHYSICIANS AND PHYSICIAN GROUPS
Massachusetts’ Group Insurance Commission (GIC) has launched a new initiative that will tier physicians by an analysis of their cost efficiency and adherence to best practices.
05-03-2006
HMOs MAY BE DUE FOR A REBOUND IN FLORIDA
While PPOs certainly continue to show membership gains in Florida, employers are again looking to HMOs for cost control.
05-03-2006
LOCAL BLUE CROSS AND BLUE SHIELD PLANS SHOW STRONG LOCAL SUCCESS IN MEDICARE PART D MEMBERSHIP
Several local Blue Cross and Blue Shield plans are among winners in Medicare Part D enrollment.
05-03-2006
NEW MUST-HAVE MEDICARE, MEDICAID, AND DUAL-ELIGIBLE ANALYSIS AND DATA SERVICE AVAILABLE FROM HEALTHLEADERS-INTERSTUDY
HealthLeaders-InterStudy announces the availability of Medicare Insider, the first comprehensive data and analysis service that helps businesses make sense of the ever-changing Medicare landscape. It is the only product available today that offers insights and data on Medicare, Medicaid, and dual-eligibles.
04-26-2006
HARRISBURG-AREA HOSPITAL SYSTEMS STABLE AND PROFITABLE
A relatively unchanging economy and little population growth have allowed Harrisburg-area hospital systems to establish a stable provider market with limited competition.
04-19-2006
ARIZONA FACES SOME SPECIFIC PROBLEMS IN PROVIDING HEALTHCARE ACCESS FOR THE UNINSURED
While Arizona faces the same challenge of treating the uninsured as many states, it has some special problems of its own.
04-12-2006
HOUSTON HOSPITALS LOOK TO PHYSICIAN PARTNERSHIPS TO OFFSET LOSSES FROM UNINSURED
Houston’s hospitals are caught in a vicious cycle of rising uncompensated costs from a growing uninsured population combined with an increasing loss of inpatient volume to physician-owned hospitals.
04-11-2006
RADIOLOGY SEEN AS NEXT COST BATTLEGROUND BETWEEN HEALTH PLANS AND PHYSICIANS
Radiology now a cost driver surpassing prescription drugs
04-10-2006
NINE NEW HEALTH PLANS ENTER THE TEXAS MEDICARE MARKET
Texas is seeing a number of new health plans gaining Centers for Medicare & Medicaid Services (CMS) approval.
04-04-2006
MARYLAND LIGHTENS HEALTH INSURANCE BURDEN ON SMALL BUSINESSES
Maryland’s PharmFlex, a basic pharmacy plan with less stringent mandates, will be available July 1, 2006.
03-29-2006
REGULATIONS KEEP SEATTLE-AREA HOSPITAL CONSTRUCTION LIMITED
Unlike most metropolitan areas with rapidly growing suburbs, Seattle is not seeing an acute-care hospital building boom.
03-22-2006
CHARLOTTE-AREA HOSPITAL SYSTEMS COMPETE FOR FACILITY IN SOUTH CAROLINA’S YORK COUNTY
Four Charlotte-area health systems are competing to build a hospital in the growing Fort Mill or Rock Hill area of York County, South Carolina.
03-21-2006
LED BY REGENCE BLUECROSS BLUESHIELD, OREGON HEALTH PLANS INCREASE REVENUE
Overall net income nearly doubled for Oregon health insurers during the first six months of 2005 compared with the same time the year before.
03-20-2006
MANY WISCONSIN SENIORS JOINING SENIORCARE TO PUT OFF MAKING A DECISION ON MEDICARE PART D
Enrollments in SeniorCare, a Wisconsin drug benefit program aimed at low-income seniors, have risen over the past year.
03-15-2006
MOLINA HEALTHCARE INC. IS DRAMATICALLY EXPANDING ITS PRESENCE IN BOTH MEDICARE AND MEDICAID IN MICHIGAN
Molina Healthcare Inc. is making a significant expansion of its presence in both the Medicaid and Medicare markets in Michigan.
03-13-2006
EMPLOYERS CONCERNED ABOUT CONSOLIDATION OF COLORADO HEALTH PLANS
UnitedHealth Group’s recent acquisition of PacifiCare makes it the largest insurer in Colorado.
03-07-2006
HEALTH PLANS ADAPTED RAPIDLY TO A POST-HURRICANE LOUISIANA HEALTHCARE MARKET
Large insurers were able to regroup quickly and maintain operations in the wake of hurricanes Rita and Katrina.
03-06-2006
FOR-PROFIT HOSPITAL GROWTH IN WEST PALM BEACH HITS SPEED BUMP
An earlier trend toward greater hospital profitability in the West Palm Beach area was reversed in 2004, with eight area hospitals in the red.
02-28-2006
SAN ANTONIO EMERGING AS INNOVATIVE MARKET IN MANAGED CARE
San Antonio-area health plans are focusing on developing innovative plan designs for the individual healthcare coverage market.
02-22-2006
CLEVELAND HEALTH SYSTEM COOPERATION FADES AS PROFITS INCREASE
Recent cooperation between the Cleveland Clinic Health System and University Hospitals Health System (UHHS) owes more to market financial instability and less to collaborative good will.
02-22-2006
RALEIGH HEALTH PLANS LEAD WAY TO A POST-HMO HEALTHCARE WORLD
The three largest health plans serving the Raleigh region have posted positive earnings in recent years, despite a long-term decline in HMO enrollment.
02-07-2006
DESPITE SERIOUS MEDICAID PROBLEMS, MISSOURI LEGISLATURE HOLDS OFF ON IMPLEMENTING RECOMMENDED REFORMS
The Missouri General Assembly does not seem to be acting on the recommendations of the Missouri Medicaid Reform Commission, formed last year to propose changes to the state-federal health benefit for the poor.
02-01-2006
REGIONAL HEALTH PLANS IN NEW YORK, NEW JERSEY, AND CONNECTICUT REMAIN STRONG DESPITE ACQUISITIONS BY NATIONAL PLANS
Although national giant WellPoint Inc. is making a major move into New York with the acquisition of five-million-member WellChoice Inc., it will be a few years before insurers in the area feel the pinch.
01-31-2006
INDIANAPOLIS’S UNREGULATED HOSPITAL MARKET CONTINUES ITS BUILDING BOOM
The current hospital building boom in Indianapolis benefits from the lack of regulation, which leaves health systems largely free from constraint by government, health insurers, and employers.
01-30-2006
GARAMENDI SEEKS TIGHTER REGULATION OF PPOS
California Insurance Commissioner John Garamendi will be seeking tighter regulation of Preferred Provider Organizations (PPOs), a form of health insurance product favored by consumers in recent years over more-restrictive HMOs.
01-25-2006
GREENSBORO-AREA HOSPITAL BUILDING BOOM FOCUSED ON EMERGENCY DEPARTMENTS
The three large hospital systems in Greensboro, Winston-Salem, and High Point are responding to rapid increases in emergency room admissions with multimillion-dollar capital expenditures for new, larger emergency departments.
01-17-2006
FINAL PASSAGE OF “ANY WILLING PROVIDER” LAW WILL SHAKE UP THE LITTLE ROCK HEALTHCARE MARKET
The recent enforcement of Arkansas' “any willing provider” law will shake up Little Rock’s highly consolidated healthcare market.
01-10-2006
TOP TEN HEALTHCARE TRENDS OF 2006
Medicare, Mergers, and Pay-for-Performance Are Among Top Stories in the Coming Year
12-27-2005
MOVEMENT OF MID-ATLANTIC SENIORS INTO MEDICARE ADVANTAGE PLANS LIKELY TO BE SLOW
Seniors in Virginia, Maryland, and Washington D.C. are seeing a bewildering variety of choices, both in Medicare Advantage and stand alone prescription drugs plans (PDPs).
12-27-2005
WASHINGTON MEDICARE PLANS FACE SERIOUS PRICE CHALLENGE FROM NEW ENTRANTS HUMANA AND UNITED
Local Medicare plans in Washington face serious price competition from large national plans entering a newly competitive market.
12-21-2005
ANALYSIS OF NEW ORLEANS HEALTHCARE SYSTEM POST KATRINA FINDS THAT THE MARKET IS YEARS AWAY FROM FULL RECOVERY
Hundreds of Physicians Have Left the Region, Health Insurers Facing Decreased Membership, and 9 Major Hospitals Closed Indefinitely. Difficult Decision-making for the Foreseeable Future
12-20-2005
IN THE TWIN CITIES’ HIGHLY INTEGRATED HEALTHCARE MARKET, PROVIDERS AND INSURERS WORK TOGETHER
A few strong healthcare providers and insurers, all with roughly equal market shares, dominate the Minneapolis-St. Paul, Minnesota healthcare market.
12-19-2005
DESPITE CHALLENGES, EL PASO’S TWO DOMINANT HEALTH SYSTEMS CONTINUE TO SHOW PROFITS, ACCORDING TO HEALTHLEADERS-INTERSTUDY
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that El Paso, Texas’ two major hospital systems, Sierra Providence Health Network, owned by Tenet, and Las Palmas-Del Sol Regional Healthcare System, owned by HCA, continue to compete vigorously in a market marked by low wages and a high uninsured rate.
12-19-2005
TULSA HEALTHCARE MARKET INCREASINGLY DOMINATED BY PHYSICIAN-OWNED SPECIALTY FACILITIES, ACCORDING TO HEALTHLEADERS-INTERSTUDY
Physician-owned specialty ventures have created lucrative opportunities in Tulsa, Oklahoma, which lacks a publicly funded hospital and has a high rate of uninsured, HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, has found.
12-14-2005
NASHVILLE-BASED HEALTHSPRING’S PUBLIC OFFERING A SIGN OF CONFIDENCE IN THE FUTURE OF MANAGED MEDICARE, ACCORDING TO HEALTHLEA
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that HealthSpring Inc.’s initial public offering reveals the insurer’s confidence in the business potential of managed Medicare.
12-13-2005
AFTER SEVERAL YEARS OF STASIS, MANAGED MEDICAID ON THE RISE AGAIN
National Medicaid Plans And Aetna’s Medicaid Unit Gaining Contracts Across The Country As States Feel Financial Pressure, According To HealthLeaders-InterStudy
12-12-2005
WORCESTER’S TWO MAJOR HEALTH SYSTEMS BOTH IN MIDST OF REJUVENATION, ACCORDING TO HEALTHLEADERS-INTERSTUDY
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that both UMass Memorial Health Care and Saint Vincent Healthcare are entering a promising era of new growth.
12-07-2005
RECENT HOSPITAL SYSTEM MERGER HIGHLIGHTS CONTINUING STRENGTH OF LOUISVILLE-AREA INTEGRATED HEALTH SYSTEMS, ACCORDING TO HEALT
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that the merger between Jewish Hospital HealthCare Services (JHHS) and CARITAS Health services, the Louisville area's second and fourth-largest health systems, creates a challenger to Norton Healthcare as the area's largest integrated health system.
12-07-2005
THE FINANCIAL HEALTH OF SYRACUSE HOSPITALS CONTINUES TO IMPROVE, ACCORDING TO HEALTHLEADERS-INTERSTUDY
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that each of the four largest area health systems and hospitals in the Syracuse, New York healthcare market finished 2004 in the black.
11-30-2005
FRESNO'S COMMUNITY MEDICAL CENTERS SHOWS SERIOUS LOSSES, DRIVEN BY ITS CARDIAC HOSPITAL, ACCORDING TO HEALTHLEADERS-INTERSTUD
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that Community Medical Centers (CMC), which dominates Fresno's hospital market, continues to show serious losses, driven by its for-profit Fresno Heart Hospital.
11-30-2005
MICHIGAN HMOs HOLD STEADY AGAINST RISE OF PPOs, ACCORDING TO HEALTHLEADERS-INTERSTUDY
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that Michigan commercial HMOs showed only minor decline in membership over 2004.
11-29-2005
GROWTH OF PHYSICIAN-OWNED SPECIALTY HOSPITALS IN OKLAHOMA CITY CONTINUES, ACCORDING TO HEALTHLEADERS-INTERSTUDY
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that because of its relatively loose certificate-of-need laws, Oklahoma City has become an attractive market for physicians partnering with investors in developing specialty hospitals.
11-29-2005
HUMANA SET TO BE THE SOLE REGIONAL MEDICARE PPO IN WISCONSIN, ACCORDING TO HEALTHLEADERS-INTERSTUDY
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that Humana Inc. is the only company offering a regional Medicare PPO in the Illinois-Wisconsin Medicare Advantage Region.
11-28-2005
COMPETITION TO BE INTENSE AMONG HEALTH INSURERS OFFERING MEDICARE DRUG PLANS IN CALIFORNIA, ACCORDING TO HEALTHLEADERS-INTERS
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that health insurers offering Medicare's new prescription drug discount plan to 4.3 million eligible seniors in California are bracing for a costly and competitive campaign for market share.
11-09-2005
HUMANA SET TO SHAKE UP PENNSYLVANIA MEDICARE MARKET, ACCORDING TO HEALTHLEADERS-INTERSTUDY
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that Humana Inc.'s regional PPO and competitively priced stand-alone drug plan will challenge local Pennsylvania Medicare plans.
11-08-2005
GEORGIA HMOS CONTINUE TO DROP IN HEALTHCARE MARKET SHARE, ACCORDING TO HEALTHLEADERS-INTERSTUDY
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that five of Georgia's HMOs experienced enrollment declines in 2004.
11-07-2005
DEFYING NATIONAL TRENDS, HMOS REMAIN POPULAR IN MASSACHUSETTS, ACCORDING TO HEALTHLEADERS-INTERSTUDY
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that Massachusetts has the highest HMO healthcare market penetration of any state.
11-01-2005
MANY CHOICES FOR MEDICARE PRESCRIPTION DRUG PLANS, FEW CHOICES FOR MEDICARE ADVANTAGE PLANS IN KANSAS AND MISSOURI, ACCORDING
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that while many insurers will be offering prescription drug plans (PDPs) to Kansas and Missouri seniors, only Humana will be offering a regional PPO in the two Medicare Advantage regions that include Kansas and Missouri.
10-24-2005
DESPITE A SLIP IN HMO ENROLLMENTS, FLORIDA REMAINS AN ATTRACTIVE HEALTHCARE MARKET, ACCORDING THE HEALTHLEADERS-INTERSTUDY
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that despite a slip in HMO enrollment, new HMOs continue to enter the Florida market.
10-19-2005
ACQUISITION OF WELLCHOICE POSITIONS WELLPOINT TO SIGNIFICANTLY INCREASE ITS HEALTH INSURANCE BUSINESS IN THE TRISTATE AREA,
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that WellPoint Inc.'s recent acquisition of WellChoice Inc. cements WellChoice's dominant healthcare market position in the TriState area.
10-19-2005
AETNA, MOLINA, AND UNICARE AMONG HEALTH PLANS MOVING INTO THE TEXAS MEDICAID MARKET, ACCORDING TO HEALTHLEADERS-INTERSTUDY
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that Texas is planning to move two thirds of its current state-managed fee-for-service Medicaid members into managed care.
10-17-2005
AFTER YEARS OF LOSSES, ROCHESTER-AREA HOSPITALS SHOW FINANCIAL GAINS RELATIVE TO THE REST OF THE STATE, ACCORDING TO HEALTHLE
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that Rochester-area hospitals are doing well relative to other New York State hospitals, though less well in national terms.
10-17-2005
RECENT MEDICARE CHANGES ARE BRINGING A VARIETY OF NEW HEALTH PLANS TO THE TRISTATE AREA, ACCORDING TO HEALTHLEADERS-INTERSTUD
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that health plans are offering many new PPOs in New York, New Jersey, and Connecticut.
10-13-2005
MEDICARE PRESCRIPTION DRUG PLAN COMPETITION ABOVE AVERAGE IN SOUTH CAROLINA, ACCORDING TO HEALTHLEADERS-INTERSTUDY
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that South Carolina has more Medicare prescription drug plans (PDPs) than Florida, even though Florida has a senior population five times as big.
10-04-2005
ILLINOIS MEDICAID CUTS DRIVE OUT HUMANA AND UNITEDHEALTH GROUP, ACCORDING TO HEALTHLEADERS-INTERSTUDY
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that Humana Inc. and UnitedHealth Group have quietly pulled out of the Illinois managed Medicaid market.
10-04-2005
MEDICARE DRUG-BENEFIT PLAN COMPETITION FOR SENIORS WILL BE INTENSE IN THE MIDWEST, ACCORDING TO HEALTHLEADERS-INTERSTUDY
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that local Ohio, Kentucky, and Indiana Medicare drug-benefit plans will be competing fiercely with offerings from national plans such as WellPoint, UnitedHealth Group, and Humana Inc.
10-03-2005
MID-ATLANTIC HEALTH PLANS SHOWED SOLID PROFITS IN 2004
Earnings Should Lead To Investment In Technology-Driven Quality Programs, According To HealthLeaders-InterStudy.
09-28-2005
AMBITIOUS WISCONSIN HEALTHCARE PARTNERSHIP ANTICIPATES DOUBLE-DIGIT COST SAVINGS, ACCORDING TO HEALTHLEADERS-INTERSTUDY
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that a partnership between the Business Health Care Group of Southeast Wisconsin and Humana Inc. promises to show significant healthcare cost savings.
09-23-2005
HOW ARE THE NEWLY APPROVED MEDICARE PRESCRIPTION DRUG PLANS LIKELY TO PERFORM?
Center for Medicare & Medicaid Services issued its approval to plans that will offer Medicare prescription drug coverage starting January 1, 2006.
09-13-2005
CIGNA INCREASES HEALTHCARE MARKET SHARE IN TENNESSEE, ACCORDING TO HEALTHLEADERS-INTERSTUDY
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that CIGNA HealthCare of Tennessee stands to capture more than 120,000 more self-insured members in the state.
09-12-2005
CARE CHOICES HMO DRAWS EDUCATION GROUPS AWAY FROM THE MICHIGAN EDUCATION SPECIAL SERVICES ASSOCIATION, ACCORDING TO HEALTHLEA
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that the Care Choices HMO appears poised to take some educators' health business away from the Michigan Education Special Services Association (MESSA).
09-06-2005
GEORGIA HMOS SHOW MODERATE, STEADY GROWTH, ACCORDING TO HEALTHLEADERS-INTERSTUDY
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that new products, solid underwriting, and good medical management kept most Georgia HMOs in the black in 2004.
08-31-2005
DRAMATIC HOSPITAL CONSTRUCTION IN DENVER'S COMPETITIVE HEALTHCARE MARKET RESULTS IN 1,400 NEW INPATIENT BEDS
HealthLeaders-InterStudy Releases a New Version of its Market Overview Product, Covering 75 Metro Healthcare Markets, Comprising 88 Percent of the American Population.
08-30-2005
NEW ENGLAND HEALTH PLANS RELUCTANT TO OFFER MULTI-STATE, REGIONAL MEDICARE PRODUCTS
Massachusetts Health Plans Instead Announce Two New Local Medicare Products, According To HealthLeaders-InterStudy.
08-29-2005
ACQUISITION OF PACIFICARE POSITIONS UNITEDHEALTH FOR SIGNIFICANT MEDICARE GROWTH
HealthLeaders-Interstudy Sees PacifiCare's Transfer Of Chronic Care Programs To Disease-Management Vendor Alere As Key To Medicare Expansion Success.
08-23-2005
PENNSYLVANIA HMO BUSINESS PROFITABLE, BUT SHRINKING MARGINS INDICATE FUTURE CHALLENGES, ACCORDING TO HEALTHLEADERS-INTERSTUDY
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that Pennsylvania insurers were profitable in their commercial and government HMO lines of business in 2004, but that the top six revenue earners showed margins below the national industry average.
08-11-2005
TRISTATE PLANS EXPLOIT PROFIT CYCLE WITH IT INVESTMENTS, ACCORDING TO HEALTHLEADERS-INTERSTUDY
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that HMOs in Connecticut and New Jersey are in good shape financially, thanks to improved medical cost trends and disciplined underwriting.
08-09-2005
PHARMACIST-CENTERED DISEASE-MANAGEMENT PROGRAM ON THE MOVE, ACCORDING TO HEALTHLEADERS-INTERSTUDY
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that the Asheville Project's disease-management program that puts pharmacists at the center of care is preparing to expand into new areas for the third time.
08-08-2005
FLORIDA'S HMOS CONTINUE TO MAKE MONEY, ACCORDING TO HEALTHLEADERS-INTERSTUDY
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that better forecasting and disease-management systems paid off for Florida HMOs in 2004.
08-03-2005
ILLINOIS HMOS CONTINUE STRONG FINANCIAL PERFORMANCE, LED BY RECORD PROFITS FROM BLUE CROSS AND BLUE SHIELD OF ILLINOIS, ACCOR
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that all but two Illinois HMOs showed a profit in 2004, and Blue Cross and Blue Shield of Illinois led the pack with $145 million in net income.
08-03-2005
TEXAS HMOS CONTINUE STRONG FINANCIAL SHOWING, ACCORDING TO HEALTHLEADERS-INTERSTUDY
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that Texas HMOs as a whole continued a three-year streak of profits in 2004, and several individual plans improved dramatically.
08-02-2005
COMMISSION SEEKS TO REBUILD MISSOURI MEDICAID, ACCORDING TO HEALTHLEADERS-INTERSTUDY
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that a Medicaid Reform Commission has begun studying ways to rebuild Missouri's troubled Medicaid program.
07-18-2005
INDIANA'S STRUGGLING HMOs CHALLENGED BY NEW COMPETITION FROM HUMANA, ACCORDING TO HEALTHLEADERS-INTERSTUDY
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that Indiana's HMOs showed a tiny 1 percent gain in premium revenues in 2004.
07-05-2005
OREGON, WASHINGTON HEALTH PLANS IMPROVE ALONG WITH ECONOMY
Plans Will Invest in Technical and Operational Upgrades, According To New Research from HealthLeaders-Interstudy.
06-27-2005
WISCONSIN HMOs RALLY AGAINST PROPOSED MEDICAID TAX
Mass Exodus of Medicaid Plans was Feared, According to New Research from HealthLeaders-InterStudy.
06-20-2005
FULL RANGE OF MEDICARE PRODUCTS ON HORIZON IN TENNESSEE
PPOs, PFFS, Drug Plans all to be Offered, According to New Research from HealthLeaders-InterStudy.
06-08-2005
HEALTH PLANS IN CENTRAL REGION OWNED BY WELLPOINT WILL INCREASE FOLLOWING MERGER
Acquisition Will Drive Growth in Several States, Including Missouri.
06-06-2005
MICHIGAN HMOs GARNER SMALLER PROFITS IN 2004
Similar to Nationwide Trends, Consolidation is Reducing Number of HMOs in the State, According to New Research from HealthLeaders-InterStudy.
05-24-2005
HUMANA TO OFFER REGIONAL MEDICARE PPO IN FLORIDA
Plan Will Offer Benefits Similar to Insurer's Other Medicare Advantage Plans, According to New Research from HealthLeaders-InterStudy.
05-23-2005
HUMANA ANNOUNCES PLANS FOR REGIONAL MEDICARE PPOS IN GEORGIA, ALABAMA, SOUTH CAROLINA AND TENNESSEE
Most Other Insurers Reluctant to Enter Regional PPO Program, According to New Research from HealthLeaders-InterStudy
05-17-2005
NEW ENGLAND STATES FORM STRATEGIES TO CONTROL DRUG COSTS
Alternatives Being Considered Include Importing Cheaper Drugs from Canada, According to New Research from HealthLeaders-InterStudy.
05-16-2005
MAJOR CALIFORNIA HEALTH PLANS COMPETE FOR SMALL BUSINESSES
State's Health Insurance Market Leaders Offering Low-Cost Products and a Wide Range of New Options to Expanding Small-Group Market, According to New Research from HealthLeaders-InterStudy.
05-11-2005
DOWNSIZING PROFITABLE FOR CIGNA
National Insurer Achieves Dramatic Turnaround in North Carolina, According to New Research from HealthLeaders-InterStudy.
05-10-2005
MEDICAID MANAGED CARE RAMPING UP IN OHIO, INDIANA
Both States are Expanding Medicaid HMO Programs and Attracting Interest of National Medicaid Managed Care Companies, According to New Research from HealthLeaders-InterStudy.
05-09-2005
PHYSICIANS SUE OVER REIMBURSEMENTS IN KANSAS CITY
Major Health Plans Sued by Providers as Conspiracy to Suppress Payments Alleged, According to New Research from HealthLeaders-InterStudy.
05-04-2005
BLUE CROSS AND BLUE SHIELD OF TEXAS WINS
Insurer to Administer Benefits Again for Largest Group of Employees in State, According to New Research from HealthLeaders-InterStudy.
05-02-2005
OPEN-ACCESS BENEFIT MODELS ARE REDUCING HMO ENROLLMENT IN TRISTATE REGION
Even Connecticut, Previously an HMO Stronghold, Shows Declining Membership, According to New Research from HealthLeaders-InterStudy.
04-27-2005
PENNSYLVANIA'S BLUE CROSS BLUE SHIELD PLANS INTERESTED IN PARTICIPATING IN NEW REGIONAL MEDICARE PPO PROGRAM
Plans May be Well Suited to Form Partnership for a Regional PPO, According to New Research from HealthLeaders-InterStudy.
04-20-2005
PPO RENTAL NETWORKS POISED FOR GROWTH
Acquisition Activity Abounds as Rental PPOs Evolve Into Industry Heavyweights, According to New Research from HealthLeaders-InterStudy.
04-11-2005
MEDICAID PLANS IN ILLINOIS FORM LOBBY GROUP WHOSE GOAL IS TO EXPAND MEDICAID MANAGED CARE
Only 8.3% of State's 1.7 Million Medicaid Recipients are in Managed Care, According to New Research from HealthLeaders-InterStudy.
03-29-2005
MASS EXODUS FROM HMOS IN THE PACIFIC NORTHWEST IS SLOWING WHILE PPO GROWTH IS MODERATING
PPOs Still Popular, According to New Research from HealthLeaders-InterStudy.
03-28-2005
WITH A HALF MILLION RESIDENTS LACKING PRESCRIPTION DRUG COVERAGE, WISCONSIN'S EXPANDING BENEFIT PLAN SEEN AS FIX
State Officials Looking for Ways to Help, According to New Research from HealthLeaders-InterStudy.
03-08-2005
YENTREVE/ARICLAIM WILL DOMINATE EUROPEAN MARKET FOR TREATMENT OF STRESS URINARY INCONTINENCE
Sales for Stress Urinary Incontinence Treatment in the United States Will Not be as Strong, According to a New Study From Decision Resources.
03-07-2005
HMO ENROLLMENT DOWN IN SEVERAL NEW ENGLAND STATES
New Hampshire is Only New England State to Increase HMO/POS Membership in 2004, According to New Research from HealthLeaders-InterStudy.
02-22-2005
TEXAS HMO MEMBERSHIP CONTINUES DOWNWARD TREND WHILE PPO MEMBERSHIP INCREASES, ACCORDING TO NEW RESEARCH FROM HEALTHLEADERS-IN
HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that health plans are continuing the trend of shaving HMO membership in Texas.
02-16-2005
DEBIT CARD FOR SOUTH CAROLINA MEDICAID RECIPIENTS PROPOSED
Governor Mark Sanford of South Carolina Leads Fight to Control Medicaid Spending, According to New Research from HealthLeaders-InterStudy.
11-30-1999
FLORIDA EMERGENCY ROOM COSTS INCREASED 25 PERCENT IN THE LAST YEAR AND MAY LEAD TO MORE OPPORTUNITY FOR PHARMA INDUSTRY
ER Usage Trends and Growing Uninsured Population Raise Concerns for Area Providers and Insurers, According to New Report from HealthLeaders-InterStudy
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