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December 15, 2005
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MHMR Dec. 15, 2005; Volume 13, Number 21
SPECIAL REPORT: Evidence-Based Medicine...Kaiser, Aetna, BCBS-TN, UnitedHealth...Humana buys Corphealth...Centene to buy US Script...Pay-for-Performance gains...Humana Part D lives top 1 MM...United has 2 MM Part D lives...Health Net expands in OR, WA...UnitedHealth buys PacifiCare...Aetna affirms 2006 outlook...WellPoint down after warning...NM HMO profits soar...LA HMO net falls...MCO stocks rise 1%...Services stocks rise 4%...BioScrip loses Centene pact...and more...
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HUMANA BUYS CORPHEALTH FOR $54 MILLION
Humana Inc. (Louisville, KY) will take its behavioral business in-house, announcing the acquisition of Corphealth Inc. (Ft. Worth, TX), a behavioral health management company, for $54 million in cash.
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CENTENE TO ACQUIRE US SCRIPT FOR $40 MM
Centene Corp. (St. Louis) will take its pharmacy benefit management business in-house, announcing a definitive agreement to acquire privately held US Script Inc. (Fresno, CA) for $40 million in cash, plus the potential for up to $10 million in additional payments over five years if US Script hits certain cash flow targets.
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PAY-FOR-PERFORMANCE GAINS GROUND
At year-end 2005, there were 107 physician pay-for-performance programs nationwide—73 sponsored by commercial health plans, 13 by Medicaid plans, eight by the federal Centers for Medicare and Medicaid Services, seven by employer groups, and six by other organizations, according to a survey conducted by Med-Vantage (San Francisco).
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HUMANA TO HAVE 1+ MILLION PART D LIVES BY JAN. 1
Humana Inc. (Louisville, KY), which offers the lowest premiums among national Medicare drug plans (MHMR, Nov. 15), said it expects to have 1.1 million to 1.2 million lives signed up for its stand-alone Part D offerings as by Jan. 1, 2006.
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UNITEDHEALTH REPORTS 2 MILLION PART D LIVES
UnitedHealth Group (Minnetonka, MN) reported that in its first month of marketing Medicare Part D drug plans, the company has signed up more than 2 million lives for its offerings. Sales include United’s AARP Medicare Rx Plan (MHMR, Sept. 30) and comprise individual, commercial and government lives.
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HEALTH NET TO SERVE ALL OREGON COUNTIES
Health Net (Woodland Hills, CA) announced that it would expand the service area for its commercial business to cover all counties of Oregon and Washington State, effective Jan. 1, 2006.
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AETNA AFFIRMS 2005-06 EARNINGS OUTLOOK
Aetna Inc. (Hartford, CT) has reiterated that it expects operating earnings of $4.60 per share in 2005 ($1.385 billion based on 301 million diluted shares) and between $5.45 and $5.50 in 2006 ($1.624 billion to $1.639 billion based on 298 million diluted shares).
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WELLPOINT SHARES DOWN AFTER EARNINGS WARNING
WellPoint Inc. (Indianapolis) shares closed at $78.24 on Dec. 19, still down 1% from nearly two weeks ago when the company announced 2006 earnings projections that were below Wall Street estimates.
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NM HMO PROFITS INCREASE 22.7% IN 2004
New Mexico HMOs reported a 22.7% increase in net income to $45.8 million on revenues of $2.208 billion in 2004, according to an MHMR tally of state insurance department data for nine leading plans.
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LA HMOs SUFFER 17.5% DECLINE IN NET INCOME IN 2004
Louisiana HMOs posted a 17.5% decline in net income to $53.691 million in 2004 on revenues of $1.752 billion, up 3.9%, according to an MHMR tally of state insurance department data for nine leading plans.
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EVIDENCE-BASED MEDICINE IS CATCHING ON—SLOWLY
Although gains are painfully slow, the use of evidence-based medicine is picking up momentum as a strategy for curbing the nation’s healthcare cost trend, according to the Evidence-Based Medicine Data Pak and Action Guide, a new report from Corporate Research Group.
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BIOSCRIP LOSES CENTENE PBM CONTRACT
BioScrip (Elmsford, NY), which has been focused on growing its specialty pharmacy business, announced the loss of a major pharmacy benefit management customer, Centene Corp., which is taking the business in-house (see story, this issue).
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