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Managed Healthcare Market Report

May 15, 2007

MHMR May 15, 2007: Volume 15, Number 9
Universal to buy MemberHealth…Boorady urges sale of PBM units…1Q07 MCO profits rise 11%...Best upgrades Health Net…Chart: 1Q07 MCO financials…Chart: MCO profit margins… BC-CA settles class action…HMO stocks rise 0.4%...Services stocks rise 1.9%...and more…

UNIVERSAL TO BUY MEMBERHEALTH
Universal American Financial Corp. (New York), which offers health insurance to seniors, is expanding into the pharmacy benefit management business through the acquisition of privately held MemberHealth Inc. (Cleveland) for $630 million in cash and stock.

BOORADY URGES SALE OF IN-HOUSE PBMs
Citigroup (New York) analyst Charles Boorady urged managed care companies to sell or spin off their in-house pharmacy benefit management operations, arguing that owning a PBM is “more ego than economics” and “not a key success factor for health insurers that can easily outsource the function.”

1Q07 MCO PROFITS RISE 11%
First-quarter 2007 net income for 13 publicly traded managed care companies rose 11% to $2.517 billion.

BEST UPGRADES HEALTH NET CREDIT RATING
A.M. Best (Oldwick, NJ) has upgraded the issuer credit rating of Health Net (Woodland Hills, CA) to “bb+” from “bb,” reflecting improved consolidated operations.

BLUE CROSS-CA SETTLES LAWSUIT OVER RECINDED POLICIES
As part of a settlement in a class action lawsuit brought on behalf of 6000 individuals, Blue Cross of California, a unit of WellPoint Inc. (Indianapolis), agreed that it wouldn’t retroactively cancel individual health insurance coverage unless the member “intentionally misrepresented” information on the insurance application.

MANAGED CARE STOCKS RISE 0.4%
Managed care stocks rose 0.4% in the two weeks ended May 11, according to an MHMR tally of 13 issues.

MANAGED CARE SERVICES STOCKS RISE 1.9%
Managed care services stocks rose 1.9% in the two weeks ended May 11, according to an MHMR tally of 11 issues.


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