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May 31, 2008
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MHMR May 31, 2008: Volume 16, Number 10
Not-for-profits Blues strong...BCBS M&A outlook...Aetna tops in paying claims...Chart: Outlook for MCOs...Chart: Key MCO ratings drivers...Chart: BCBS plan positioning...Touchpoint to pay patient’s care...MCO stocks rise 8%...Services stocks rise 1%...PBMs
Express Scripts settles probe...and more...
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NOT-FOR-PROFIT BLUES STRONG, S&P SAYS
Despite growing competition from for-profit health plans, not-for-profit and mutual Blue Cross Blue Shield plans “remain well-positioned to retain membership,” according to a report from Standard & Poor’s (New York)
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S&P SEES MODERATE BCBS M&A ACTIVITY
Merger and acquisition activity among not-for-profit and mutual Blue Cross Blue Shield plans is expected to be “moderate” in 2008, with no large deals other than the pending merger of Highmark and Independence Blue Cross, according to a report from Standard & Poor’s (New York).
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AETNA TOPS IN PAYING CLAIMS, DATA SHOW
Aetna is the top health plan in paying claims promptly and has the lowest claims denial rate among provider clients of electronic claims software vendor AthenaHealth.com (Watertown, MA).
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TOUCHPOINT ORDERED TO PAY PATIENT’S CANCER CARE
The Supreme Court of Wisconsin upheld a lower court ruling ordering Touchpoint Health Plan Inc. (Appleton, WI) to pay for ongoing medical treatment for a boy suffering from a rare form of brain cancer.
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EXPRESS SCRIPTS TO PAY $9.5 MM TO SETTLE PROBE
Express-Scripts Inc. (St. Louis, MO) has agreed to pay $9.5 million to settle an investigation by 28 states and Washington, DC, that the company engaged in deceptive practices to encourage physicians to switch members to drugs that would yield the highest profits, even if it meant higher costs to members and health plans.
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