HealthLeaders-InterStudy, the leading provider of managed care market intelligence, reports that there could be a shakeup on the HMO front with the pending sale of Mutual of Omaha's group commercial business to rival Coventry Health Care. According to the latest Omaha Market Overview, the combined HMOs will pose a strong challenge to UnitedHealth Group's position as Omaha market leader at the same time the national insurer comes under fire from area physicians and the Nebraska Department of Insurance.
In April 2007, Coventry Health Care announced that it would acquire Mutual of Omaha's commercial employer group health business in Nebraska and Iowa as well as its national Federal Employee Health Benefits administration business.
UnitedHealth Group's plans are the largest HMO, fully insured PPO and the only provider of managed Medicaid and Medicare products in the area. However, the company and its United HealthCare of the Midlands unit are under fire from the Nebraska Department of Insurance for a history of late payments, and some physicians are threatening to stop accepting United plans. The Nebraska Department of Insurance will attempt to resolve its issues with the insurer at a hearing later this month.
"United has not endeared itself to physicians in Omaha, and an expanded Coventry might be just what is needed," states Carolyn McMeekin, HealthLeaders-InterStudy's associate director of market overview analysis. "The market shares for HMOs here are very close, and the eventual market leader likely will be whichever plan can persuade small employers that consumer-driven health plans are the way to go, as traditional managed care enrollment is stagnating."
Coventry is the parent of Mutual of Omaha's marketplace rival Coventry Health Care of Nebraska. Mutual's relationship with Coventry blossomed during the advent of Medicare Part D when Mutual, realizing it lacked expertise in pharmaceutical coverage, turned to Coventry to extend this coverage to its customers. This theme resurfaced when Mutual found itself in need of making significant investments in order to remain competitive, and again turned to Coventry, which already had this infrastructure in place to support investments in upgraded systems and new product offerings.
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