HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that Massachusetts has the highest HMO healthcare market penetration of any state. According to the latest issue of New England Health Plan Analysis from HealthLeaders-InterStudy, the number of state residents in HMOs and point-of- service plans grew from 2.6 million to 2.7 million in 2004.
"The national trend has been toward PPOs," said Ric Gross, HealthLeaders- InterStudy analyst. "But Massachusetts has strong regional health plans, including Blue Cross Blue Shield of Massachusetts, Harvard Pilgrim Health Care, Tufts Health Plan and Fallon Community Health Plan, that have good name recognition and seem to be able to maintain customer loyalty."
Blue Cross Blue Shield of Massachusetts is the state's dominant plan, with a 44.3 percent share of the managed healthcare market. Over 2004, its membership grew from 826,000 to 1.2 million.
Harvard Pilgrim Health Care continues its turnaround since 1999, when it faced bankruptcy. It has marketed heavily, and come up with flexible plan designs that have been popular.
By contrast, Tufts Health Plan, the state's third largest insurer, has shed membership, and is seeking to expand outside of the state through an alliance with CIGNA.
Other health plan news in New England:
-- Vermont legislators agreed on a Medicaid waiver proposal that caps federal spending at $4.6 billion over the next five years, while allowing the state extensive flexibility in managing its program.
-- New Hampshire has submitted a Medicaid waiver proposal that focuses on fraud prevention.
-- Seniors in Massachusetts, Rhode Island, and Vermont can choose from 17 stand-alone Medicare prescription drug plans, while those in Maine and New Hampshire have 16 choices.
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