Managed Care Landscape
Report Author: Paula Wade
Report Summary:
With commercial enrollment growth stalling over the past two years, national managed care organizations have turned to Medicaid and Medicare Advantage markets while simultaneously making strategic purchases of smaller health plans or provider groups to leverage their positions. This annual report of the Managed Care Landscape examines enrollment, benefit design and care management trends. The PowerPoint presentation looks at the MCO strategies for managing healthcare costs and examines upcoming developments related to healthcare reform. It also highlights the industry's embracing of accountable or coordinated care models. Finally, the major MCOs' strengths, weaknesses, opportunities and threats are compared and contrasted with one another.
Questions Answered In This Report:
Health carriers are just two years away from the dramatic changes prescribed through healthcare reform.
How will Blue Cross Blue Shield plans fare through the changes? What about small carriers? How have plans already reacted to changes in medical loss ratio rules?
Major MCOs are testing defined contribution plans that operate in an approach similar to 401(k) plans.
Who are leaders in this movement? What are features of private exchanges and defined contribution plan designs?
Care management has never been more at the forefront of MCO activity. What are the factors driving the care management revolution? How does technology fit into the movement? How is healthcare reform spurring the moves?
Primary Research:
Data and research gathered from HealthLeaders-InterStudy's National MCO Analyzer series, data from HealthLeaders-InterStudy, the Centers for Medicare & Medicaid Services, Kaiser Family Foundation, Congressional Budget Office and the Health and Human Services agency
Companies Mentioned In This Report:
- Aetna
- Cigna
- Coventry
- Humana
- Kaiser Permanente
- UnitedHealth Group
- WellPoint Inc.