HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that Molina Healthcare Inc. is making a significant expansion of its presence in both the Medicaid and Medicare markets in Michigan. According to the latest issue of Michigan Health Plan Analysis, Molina is launching a Medicare special needs plan (SNP) and acquiring CAPE Health Plan with its 87,000 Medicaid members.
"Medicare/Medicaid dual eligibles are poor, elderly, and tend to have many expensive and difficult-to-treat health problems," said Rick Byrne, HealthLeaders-InterStudy analyst. "The SNP model is based on the idea that chronic case management can handle the health problems of this population in an efficient and cost-effective way. Molina is betting that, with the fully risk-adjusted rates that will be paid to special needs plans in 2007, this will be a profitable line of business for them."
Molina also won SNP contracts in California, Washington, and Utah. Molina is a publicly held for-profit Medicaid health plan, and SNPs are a new line of business for the company.
Molina's acquisition of CAPE will boost its Medicaid membership in Michigan to 231,000, making it the fourth-largest HMO of any kind in the state, and the largest Medicaid plan.
Other health plan news in Michigan: * Initiatives to better manage pharmacy programs are paying off as pharmacy cost trends slow down for Michigan health plans. * Blue Cross Blue Shield of Michigan is integrating depression screening into its array of disease management programs. About Health Plan Analysis
Health Plan Analysis identifies key health plan trends, allowing healthcare businesses to create comprehensive strategic plans and sales strategies at state and local levels.
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For more information, contact: Alex Jablokow Decision Resources 781-296-2562 ajablokow@dresources.com
SOURCE: HealthLeaders-InterStudy
CONTACT: Alex Jablokow of Decision Resources, +1-781-296-2562,
ajablokow@dresources.com
