KPMG on the Outlook for Managed Care

June 30, 2010

Below are some highlights from KPMG’s 2010 Managed Care Industry Report:

  • In 2009, the largest health insurers in the U.S had combined profits of US$14.4 billion, an increase of 56 percent over 2008, even though the industry lost 2.7 million members who had health insurance the year before.
  • However, these companies are not expected to repeat their performance in 2010. The expected high unemployment rate in 2010 may further erode insurers’ highest margin and commercial membership, which declined by 2.3 percent among publicly traded insurers in 2009.
  • The U.S. health insurance market is expected to grow 7 percent annually from 2009 to 2011. However, with the implementation of reform, health insurers will face pressure to maintain profitability. Expect to see premium increases, job cuts, administrative cost reductions, and increased M&A activity.
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Doc Consolidation to Squeeze Health Plans, PWC Says

June 24, 2010

Here’s a telling graph showing the cumulative ramp-up in physicians involved in mergers and acquisitions from 2007 through March 2010.  The chart is from PricewaterhouseCoopers’ medical cost trends report based on data from Irving Levin Assoc.  Notes PWC:

Payers expect to see more negotiating power and higher prices from larger physician groups who are working in tandem with hospital systems. Eventually, consolidation is expected to produce increases in efficiencies for providers that may be passed along to payers in lower or moderated rates.


Quote of the Day: Justin Lake

June 22, 2010

UBS analyst Justin Lake commenting on the meeting set for later today between President Obama and managed care executives:

Managed Care Remains The Go To Enemy For The Democrats Even If Both Sides Do Supposedly Need Each Other: It’s All About The Rate Hikes. The new health care reform law [Affordable Care Act (ACA)] and its implementation has gotten lost in the recent headline mix of the BP Gulf oil spill and the reemerging Afghanistan War, but promoting the 2010/2011 benefits of the ACA remains a major priority of the Obama Administration, along with trashing the health insurance sector when it makes political sense.


This Week in Health Plan Market Trends

June 21, 2010

Here are the headlines from Carl Mercurio’s Health Plan Market Trends Letter for June 21, 2010.

  • HSA Concept Falls Short on Key Metric
  • HSA Plans: Four Levels of Consumer Involvement
  • 28% of HSA Transactions Are in Drug Stores, J.P. Morgan Says 
  • How OptumHealth Stacks Up
  • Top MCOs Have 12.7 Million HSA, HRA Lives
  • Leading Banks Have $5.3 Billion in HSA Assets

This Week in Health Plan Market Trends

June 14, 2010

Here are the headlines from Carl Mercurio’s Health Plan Market Trends Letter for June 14, 2010.

  • Walgreens Dumps Caremark; Everybody Loses
  • AHIP Annual Convention: Bustling, Upbeat, Vaguely Rudderless
  • 1Q10 MCO Membership Falls 0.8% to 123.3 Million 
  • 1Q10 Commercial PPO Enrollment Declines 4.8%
  • 1Q10 HMO/POS Lives Decline 2.2% to 65.3 Million
  • 1Q10 BCBS Lives Decline 5.6% to 24.5 Million
  • S&P Still Negative on Health Insurance Industry

Off to AHIP

June 8, 2010

I’m off to the AHIP annual meeting in Las Vegas.  Will report back.


This Week in Health Plan Market Trends

June 7, 2010

Here are the headlines from Carl Mercurio’s Health Plan Market Trends Letter for June 7, 2010.

  • Open Season on Health Plans Part III – BCBS-VT Agrees to Refunds
  • What’s Worrying States re. Healthcare Reform
  • Medicaid Expansion a Mixed Bag for States
  • Politics of Reform are Far From Over
  • What Happens When High-Risk Pools Run Dry?
  • Some Clarification on Covering 26-Year-Old ‘Dependents’
  • My Theory vs. Reality of Disease Management Programs

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