HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that Pennsylvania insurers were profitable in their commercial and government HMO lines of business in 2004, but that the top six revenue earners showed margins below the national industry average. According to the latest issue of Pennsylvania Health Plan Analysis from HealthLeaders-InterStudy, Keystone Health Plan East, Keystone Health Plan West, Aetna, UPMC Health Plan, HealthAmerica, and Geisinger Health Plan can expect to face future challenges to maintaining premiums.
"It looks like Pennsylvania's Blues plans will be forced to reduce surplus and reserve levels by the state," said Micaela Brown, HealthLeaders-InterStudy analyst. "They'll probably reduce their premiums in response, and that's going to put more pressure on the margins of the other health plans."
Health plan profitability is also limited by Pennsylvania's highly consolidated healthcare provider market. Hospital systems have grouped into powerful entities that have a great deal of leverage in contract negotiations.
Other health plan news in Pennsylvania: * UnitedHealth Group and Aetna are both offering innovative health insurance products for seniors, responding to the regulatory changes brought about by the Medicare Modernization Act. * A variety of other plans will be offering new or revamped Medicare HMO and PPO products in Pennsylvania, including HealthAmerica, HealthAssurance, Humana, and UPMC * Highmark began offering a health-savings account (HSA) product as its entry into the consumer-directed health plan market. 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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SOURCE: Decision Resources, Inc.
CONTACT: Alex Jablokow of Decision Resources, +1-781-296-2562,