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January 15, 2009
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MHMR January 15, 2009; Volume 17, Number 1
Aetna, United agree on Ingenix…WellPoint halts Medicare sales…SPECIAL REPORT: Managed Care Outlook for 2009…Can MCOs bounce back…Aetna, BCBS-FL, BCBS-MI, BCBS-NC, Cigna, Harvard Pilgrim, Health Partners, Humana, UnitedHealth, WellPoint…Coventry ’09 outlook falls short…MCO stocks fall 46% in 2008…A down underwriting cycle…’09 premiums to rise 6.4%...Wallgreens expands DM…Aetna cuts some NYC rates…and more…
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CAN MANAGED CARE REBOUND IN 2009
As the U.S. economy tumbled into a recession amid a spiraling financial crisis, managed care plans suffered their worst performance in years in 2008. But the poor performance wasn’t simply a result of investment losses or rising national unemployment (which affects employer-sponsored membership totals).
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AETNA, UNITED TO END USE OF INGENIX ‘USUAL, CUSTOMARY’ DATABASE
New York Attorney General Andrew Cuomo announced agreements this week with UnitedHealth Group (Minnetonka, MN) and Aetna Inc. (Hartford, CT) aimed at ending a dispute over whether health plans avoid paying a fair share of out-of-network medical costs by fraudulently manipulating physician reimbursement rates (MHMR, Feb. 15).
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WELLPOINT TO HALT MEDICARE; CUT JOBS
Government regulators told WellPoint Inc. (Indianapolis) to suspend new enrollment in Medicare Advantage and Part D plans, pending the remediation of certain compliance violations.
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MCO STOCKS FALL 46% IN 2008; HEALTH NET LOSES 78%
Managed care stocks fell 46%% in 2008, compared to a 34% drop for the Dow industrials, 38% for the Standard & Poor’s 500 index, and 41% for the Nasdaq composite, according to an MHMR tally of shares of 13 managed care organizations.
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MCOs SUFFER DOWN UNDERWRITING CYCLE, CMS SAYS
The latest national healthcare spending estimates released this month by the Centers for Medicare and Medicaid Services suggested that the recent poor performance of the managed care industry was the result of a down underwriting cycle.
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’09 PREMIUMS TO RISE 6.4%, ANALYST SAYS
Commercial managed care premium rates are expected to rise a weighted average of 6.4% in 2009, compared to a 5.9% increase in 2008, according to analyst Scott Fidel of Deutsche Bank.
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WALGREENS TO EXPAND DISEASE MANAGEMENT
Walgreens (Deerfield, IL) announced the appointment of Colin Watts to the newly created position of president of disease management for the company’s health and wellness division.
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AETNA CUTS RATES ON NYC SMALL BUSINESS PRODUCT
Aetna Inc. (Hartford, CT) has reduced premiums 8% to 12% in 2009 for the company’s NYC Community Plan aimed at small businesses in New York City. Premiums start as low as $243 per member per month.
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