Health Net National MCO Analyzer
Analyst: Taylor Holliday
Report Summary
Health Net may be focused on just three states, but one of them is the nation's largest, California, and the company is making a name for itself with its successful strategy of offering lower-priced products through the use of narrow provider networks. Health Net's focus is the small to middle-sized employer who opts for fully insured products. At the same time, Health Net is California's largest Medicaid managed care plan, and it's a significant player in the Medicare Advantage market in Arizona and in the Medicare Part D throughout the United States. In addition to commercial, Medicaid and Medicare lines, Health Net also serves TRICARE military members through an administrative-services-only contract with the Department of Defense.
Questions Answered In This Report
Health Net's narrow-network products are a key part of its strategy for retaining and growing commercial clients. What discounts do the networks provide? What provider systems are part of the networks? What is the latest large account to adopt the narrow-network concept?
Health Net was given the go-ahead in the summer of 2011 to begin marketing its Medicare Advantage and stand-alone Part products. How much did the company's Medicare enrollment decline while it was under sanctions from the Centers for Medicare & Medicaid Services? How does it structure those benefits?
Health Net's pharmacy benefits tend to be on the rich side, owing to regulations in California and other states. What are key features of its prescription drug benefit? Who does the company contract with for pharmacy benefit management? What is its specialty drug strategy?
Primary Research
Analysis of data from HealthLeaders-InterStudy, SEC reports, data from Centers for Medicare & Medicaid Services
Companies Mentioned In This Report
- CVS Caremark
- Health Net
- Kaiser Permanente
- Sutter Health
- UnitedHealthcare