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Managed Healthcare Market Report

Managed Care Companies

MANAGED CARE STOCKS RISE 4%
Managed care stocks got off to a strong start in 2005, rising 4% in the two weeks ended Jan. 14, according to an MHMR tally of 19 issues.

MCO STOCKS TROUCE MARKET IN 2004; CENTENE, SIERRA WIN
Managed care stocks rose 53% in 2004, according to an MHMR tally of 17 issues, far outpacing broader stock market indexes for the fifth straight year.

SUPREME COURT DECLINES TO REVIEW HMO CLASS ACTION
It looks like 2005 will finally be the year when managed care organizations have to face a trial in a class action lawsuit brought by more than 900,000 physicians who claim they have been systematically short-changed by managed care plans on claims payments.

BORSCH TOPS ANALYSTS IN ’04 HMO STOCK PICKS
Matthew Borsch of Goldman Sachs (New York), who chose Aetna as his lone managed care stock pick in 2004, beat out seven other analysts surveyed by MHMR with an 85% return for the year.

WALL STREET ANALYSTS MOSTLY UPBEAT ABOUT ‘05
Managed care analysts interviewed by MHMR remained mostly upbeat on the managed sector in 2005, with the exception of Matthew Borsch of Goldman Sachs who remains neutral on the sector in general.

’05 MCO PREMIUM YIELDS, COSTS IN LINE, ANALYST SAYS
Premiums yields in the 9% to 9.5% range in 2005 will be roughly in line with medical cost trends among managed care organizations, according to Scott Fidel of JPMorgan (New York).

’05 MANAGED CARE PROFITS TO GROW 4-5%, CRG SAYS
Managed care industry profits are projected to grow another 4% to 5% in 2005, according to the newly released Outlook for Managed Care, 2005, a 120-page annual report prepared by MHMR.

MCO PROFIT MARGINS NEAR 5% IN 2004
Managed care industry profit margins rose to 4.8% among 15 publicly traded managed care organizations through the first nine months of the year, compared to the same period a year earlier.

MANAGED CARE EXECUTIVES SEE STEADY GAINS IN 2005
Managed care industry executives interviewed by MHMR said they expected continued strong financial performance in 2005, despite a slowdown in premium rate hikes and continued frustration on the part of employers regarding the cost of healthcare.

GROUP HEALTH NAMES OSTREM VP, EASTSIDE
Group Health Cooperative (Seattle) has named Jill Ostrem vice president, eastside, to spearhead the company’s expansion into East King County. Plans include a $100 million specialty facility as well as new primary care facilities.

UNITEDHEALTH POSTS 46% GAIN IN 4Q NET INCOME
UnitedHealth Group (Minnetonka, MN) reported fourth-quarter 2004 net income of $739 million, up 46% from the same period a year earlier, on revenues of $10.511 billion, up 40%.

PACIFICARE COMPLETES ACQUISITION OF AMSG
PacifiCare Health Systems (Cypress, CA) has completed the acquisition of American Medical Security Group (MHMR, Sept. 15) for $505 million in cash.

AMERIGROUP COMPLETES PURCHASE OF CAREPLUS
Amerigroup (Virginia Beach, VA) has completed the acquisition of CarePlus (New York) for $107 million (MHMR, Oct. 31, 2004).

AETNA TO ADD 4 MEDICARE ADVANTAGE COUNTIES IN NJ, MD
Aetna Inc. (Hartford, CT) will offer Medicare Advantage coverage in four new counties in New Jersey and Maryland and expand options in five other counties in these two states plus Pennsylvania. New counties in New Jersey include Burlington, Gloucester and Morris.

HUMANA TO ADD 14 MEDICARE PPO MARKETS
Humana (Louisville, KY) said it would offer a Medicare Advantage PPO in 14 markets effective Jan. 1, 2005.

CENTENE WINS KS, OH MEDICAID BEHAVIORAL CONTRACTS
Centene Corp. (St. Louis) said it will generate $4 million in 2005 from new contracts in Kansas and Ohio to provide behavioral healthcare services to Medicaid and Children’s Health Insurance Program recipients.

HARVARD PILGRIM EYES 25,000+ LIVES FROM UNITED PACT
Harvard Pilgrim (Wellesley, MA) expects its national alliance with UnitedHealth (Minnetonka, MN) to attract 25,000 to 42,000 lives in 2005, according to Charles Baker, Harvard Pilgrim’s chief executive.

CIGNA SETTLES SPECIALTY PROVIDER SUIT FOR $11.6 MM
Cigna Corp. (Philadelphia) will pay specialty providers $11.6 million as part of a settlement in a class action lawsuit brought on behalf of 210,000 specialty healthcare providers who claimed they were systematically shortchanged on claims payments.

CIGNA HMOs GET UPGRADED FINANCIAL STRENGTH RATING
Citing “refocused underwriting, streamlined administration and revised medical management,” ratings firm A.M. Best (Oldwick, NJ) has upgraded the financial strength ratings of several HMOs of Cigna Corp. (Philadelphia).

WELLPOINT INTEGRATION UNDER WAY
WellPoint Inc. (Indianapolis) is wasting no time in consolidating the former Anthem and WellPoint Health Networks organizations.

CA PREMIUM RATES RISE 11.4% IN 2004
California premium rates for fully funded healthcare insurance rose 11.4% in 2004, compared to a 15.8% increase in 2003, according to the California HealthCare Foundation and Health Research and Educational Trust (Oakland, CA).

BCBS-FL RATINGS UPGRADED BY MOODY’S
Ratings firm Moody’s Investors Service (New York) upgraded the financial strength and surplus notes ratings of Blue Cross Blue Shield of Florida (Jacksonville, FL), citing dramatically improved profitability.

MN EXPECTS ’05 HEALTH COSTS TO RISE 15%
The state of Minnesota expects single monthly healthcare costs to rise 15% to $369 in 2005 for its self-insured Advantage Health Plan program, according to data from the Dept. of Employee Relations.

CAREFIRST APPEALS DELAWARE SEPARATION
CareFirst Inc. (Bethesda, MD) appealed to the Delaware Supreme Court seeking to overturn the state insurance commissioner’s June 2004 order that the company sever its affiliation with Blue Cross Blue Shield of Delaware.


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