Medicare Special Needs Plans Focused on Chronic Conditions Expand Into Texas

HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, reports that Texas is poised to be an explosion site for Medicare special needs plans (SNP) in 2007. According to the latest Texas Health Plan Analysis, XLHealth, a Baltimore- based disease management firm, recently announced expansion of its SNP to Texas through its Care Improvement Plus plan.

"The state's high Medicare population and prevalence of certain chronic illnesses have made the state attractive to XLHealth," states Ric Gross, HealthLeaders-InterStudy research analyst.

XLHealth began marketing October 1 to around 580,000 Medicare eligible beneficiaries, with open enrollment beginning November 15 for a January 1, 2007, effective date. The plan will enroll chronically ill Medicare beneficiaries living with diabetes, heart failure, chronic obstructive pulmonary disease, and/or end-stage renal disease.

Texas is a good market for a chronic condition SNP, particularly due to the significant number of Hispanics who have a higher prevalence of diabetes. XLHealth recognizes the need for addressing the care of these patient populations and the costs associated with them.

Texas currently has 14 SNPs in operation, 13 enrolling dual-eligibles and one the institutionalized; XLHealth is the first announced plan to focus on chronic conditions.

  Other health plan news in Texas:   * Texas' continuing expansion into Medicaid managed care is attracting     Aetna, Molina Healthcare and UniCare to its state program and is     sharply expanding managed care for the Aged, Blind and Disabled     population.    * Midland Surgical Associates, wanting higher reimbursement rates, has     walked away from UnitedHealth's network in a contracting dispute     mirroring others around the country.    About Health Plan Analysis 

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HealthLeaders-InterStudy is the authoritative source for managed care data and analysis. For more information, please visit http://www.healthleaders-interstudy.com/.

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  For more information, contact:    Kelly Morphy   HealthLeaders-InterStudy   615-369-4818   kmorphy@healthleaders-interstudy.com 

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SOURCE: HealthLeaders-InterStudy