HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that UnitedHealth Group's acquisition of PacifiCare Health Systems positions the combined company to capitalize on the Medicare prescription drug benefit scheduled to start January 1, 2006. According to the latest issue of California Health Plan Analysis from HealthLeaders-InterStudy, PacifiCare has already bid to market a nationwide pharmacy-only Prescription Drug Plan (PDP) under the new Medicare Part D Drug Benefit. Contracts will be awarded in September.
"PacifiCare is the largest for-profit provider of Medicare health plans in the country," said Sheri Sellmeyer, HealthLeaders-InterStudy senior analyst. "The merger more than triples United's Medicare membership. In addition to their pharmacy plan stake, PacifiCare has approval to offer Medicare Advantage fee-for-service plans in California and 15 other states."
Just prior to the merger announcement, PacifiCare transferred its entire disease-management program to Alere Medical, tripling Alere's size. Alere is already involved in Medicare demonstration projects covering some 800,000 lives, more than any other disease management vendor. HealthLeaders-InterStudy sees Alere's specialist approach to chronic care as key to the financial success of their Medicare expansion.
Other health plan news in California: * Molina Healthcare, a Medicaid managed care organization, acquired 83,000 new members from Sharp HealthCare in San Diego county after losing a bid for members in Riverside and San Bernardino counties. * Blue Shield of California has been the fastest-growing health plan in California over the last three years. * The California Public Employees Retirement System (CalPERS) raised its premium rates for 2006 by 8.7 percent, a significantly lower increase than in previous years, signaling a continuation of its efforts to curb healthcare costs. About HealthLeaders-InterStudy
HealthLeaders-InterStudy, a newly formed company of Decision Resources, Inc. (http://www.decisionresources.com/), is the authoritative source for managed care data, analysis, and news. For more information, please visit both Web sites at http://www.healthleaders.com/ and http://www.interstudypublications.com/.
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