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March 31, 2005
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MHMR March 31, 2005: Volume 13, Number 6
SPECIAL REPORT: PBM Outlook...PBMs gear up for Medicare drug...Medco targets Part D rebates...Chart: PBM members, claims...Caremark, Express Scripts, Medco, MedImpact, NMHCS, Prime, PharmaCare, Prescription Solutions...WellPoint to offer Part D plan...PacifiCare targets Medicare drug...TX HMO net income soars...BCBS-MI promotes Loepp...Aetna, Coventry win PBGH...BCBS-MN ’04 margin is 0.6%...Chart: TX HMO financials...OK HMO net doubles...Chart: OK HMO financials...Best affirms BCBS-FL ratings...People: Rishell...HMO stocks fall 5%...HMO services stocks fall 2%...Matria completes Miavita deal...Horizon raises $60.5 million...and more...
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PBMs GEAR UP FOR MEDICARE PART D
Pharmacy benefit management companies face tough competition, a consolidating market, tightening margins and regulatory uncertainty. But that’s all old news. What’s occupying the minds of PBM executives these days is how to capitalize on the biggest new opportunity in the history of the Medicare program—the Part D drug benefit that takes effect in 2006.
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MEDCO SEES PART D REBATES AS KEY
Medco Health Solutions (Franklin Lakes, NJ) has signed an agreement that provides preferred formulary status for a broad array of prescription medications from GlaxoSmithKline (Research Triangle Park, NC) in exchange for rebates, the company announced.
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TX HMO NET INCOME SOARS
Texas HMOs reported net income of $158.502 million through nine months of 2004, up 46% from the same period a year earlier, according to data from the Texas Dept. of Insurance.
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BCBS-MI TO PROMOTE LOEPP TO CEO
Blue Cross Blue Shield of Michigan (Detroit) has promoted Daniel Loepp to president and chief executive, effective in mid-2006 after the retirement of current company head Richard Whitmer. Loepp, 47, is currently senior vice president and chief of staff. He joined the company in 2000.
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WELLPOINT TO OFFER PART D PRESCRIPTION DRUG PLAN
WellPoint Inc. (Indianapolis) has announced plans to offer a national prescription drug plan under the Medicare Part D drug program, including options for individuals, low-income beneficiaries, and members already enrolled in the company’s Medicare Advantage plans.
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PACIFICARE TO OFFER NATIONAL MEDICARE DRUG PLAN
PacifiCare Health Systems (Cypress, CA) will join the chorus of companies lining up to provide a national prescription drug program through the Medicare Part D program, which takes effect Jan. 1, 2006.
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AETNA, COVENTRY TO ADMINISTER PITTSBURGH GROUP
The Pittsburgh Business Group on Health (Pittsburgh) has chosen Aetna Inc. (Hartford, CT) as the preferred national administrator of the group’s newly launched self-insured group purchasing option.
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OK HMOs DOUBLE PROFITS THROUGH 9 MONTHS 2004
Oklahoma HMOs reported net income of $24.865 million through nine months of 2004, up 112% compared to the same period a year earlier, according to an MHMR tally of state insurance department data for seven leading plans.
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BEST AFFIRMS BCBS-FL RATINGS
Citing “strong brand image and strong operating performance,” A.M Best (Oldwick, NJ) has affirmed its debt rating for Blue Cross Blue Shield of Florida Inc. (Jacksonville) of “bbb+” for $150 million in 8.25% surplus notes due 2011.
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PEOPLE: RISHELL
Blue Cross Blue Shield of Louisiana (Baton Rouge, LA) confirmed that chief financial officer Mark Rishell has left the company this month to pursue other interests. The decision to leave was mutual, according to a BCBS-LA spokesman. In November, BCBS-LA named Gery Barry chief executive (MHMR, Nov. 15, 2004).
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HORIZON HEALTH RAISES $62.5 MM
Horizon Health Corp. (Lewisville, TX) raised $62.5 million in net proceeds from the secondary public offering of 1.725 million shares of common stock at $36.25 per share.
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