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Research & Reports

Searching in Market Access (2019)

Category

2015 Market Access Reports

The HealthLeaders-InterStudy Market Analyst team analyzes major developments at...
The HealthLeaders-InterStudy Market Analyst team analyzes major developments at the nation’s publicly held health plans each quarter through their financial releases and conference call transcripts. The summaries focus on state highlights, product news and significant corporate...
The state agency that manages the Medicaid managed care program is keeping seven...
The state agency that manages the Medicaid managed care program is keeping seven of its current managed care plans in its latest procurement, and it will add a subsidiary of Centene Corp. to its line-up. However, the service areas are shifting dramatically with a number of current plans set to lose...
Blue Cross Blue Shield of Illinois is adding a new twist to its HMO product, in...
Blue Cross Blue Shield of Illinois is adding a new twist to its HMO product, in the form of a new offering in the Blue Edge suite pairing the HMO with a Health Reimbursement Arrangement. Illinois' Medicare Advantage plans have reimbursement rates running at about $20 per member per month lower...
Healthy Indiana Plan, which was created in 2007, is experiencing one of the...
Healthy Indiana Plan, which was created in 2007, is experiencing one of the fastest launches of any Medicaid-expansion program in the country. By mid-2008, the program had more than 14,000 Hoosiers enrolled and another 7,400 applications pending; it offers medical and pharmacy benefits along with a...
Kaiser Permanente of Colorado has agreed to provide $155 million in premium...
Kaiser Permanente of Colorado has agreed to provide $155 million in premium credits to Colorado consumers, translating to a $287 credit to individual and family plan members in 2009 and 2010. The agreement settles concerns by regulators that the company was sending too many financial reserves to...
Iowa's governor has signed a healthcare reform law that increases coverage...
Iowa's governor has signed a healthcare reform law that increases coverage for children with family incomes up to 300 percent of the federal poverty level. The legislature also expanded the ability of insurers to offer health insurance to dependent children until they are 25. A statewide...
Health plans in the Carolinas are managing specialty pharmacy costs at virtually...
Health plans in the Carolinas are managing specialty pharmacy costs at virtually every step of the process, from negotiating prices with manufacturers to creating special convenient networks. Blue Cross and Blue Shield of North Carolina has developed its own specialty pharma network and is aligning...
TennCare, the large Medicaid managed care program, recently awarded two new...
TennCare, the large Medicaid managed care program, recently awarded two new contracts to health plans to manage the care for enrollees in west and east portions of the state. The contracts went to AmeriChoice, a unit of UnitedHealth Group, and to BlueCross BlueShield of Tennessee. The contract were...
Two collaborative efforts involving multiple health insurers in Pennsylvania...
Two collaborative efforts involving multiple health insurers in Pennsylvania have the potential to improve the quality of healthcare in the state. The first is a transparency effort involving how care is delivered at 160 hospitals in four major categories of medical care. The second is a medical...
Wisconsin is joining the ranks of states who are carving out the pharmacy...
Wisconsin is joining the ranks of states who are carving out the pharmacy benefits in their Medicaid and other health programs in an attempt to maximize rebates from drug manufacturers. And though the state says it hopes to save $26 million by taking on management of the pharmacy operations,...
Maryland has become one of the first states to pass laws regulating the...
Maryland has become one of the first states to pass laws regulating the licensing and transparency of pharmacy benefits managers operating in the state. The bills were supported by the Pharmaceutical Care Management Association, which represents PBMs. The Maryland General Assembly also considered...
Blue Cross Blue Shield of Michigan got only a portion of the insurance reforms...
Blue Cross Blue Shield of Michigan got only a portion of the insurance reforms it sought in the Michigan legislature, at least in part because of opposition from its competitor health plans. But the changes will have effects on Michigan's healthcare market going forward. One of the Blues'...
Summary Healthcare reform fizzled out in both Kansas and Missouri in the past...
Summary Healthcare reform fizzled out in both Kansas and Missouri in the past legislative sessions. A legislative revolt from his own party forced Missouri Gov. Matt Blunt to back off his Insure Missouri plan. And what few pieces from the Kansas Health Policy Authority proposal survived went largely...
Passage of the state's new Cover Florida program is likely to put some of...
Passage of the state's new Cover Florida program is likely to put some of the 3.8 million uninsured residents into health insurance, but critics question how much help the low-premium/limited benefits plan can provide given the wide variety of low-cost designs already available on the market....
New York's proposal to curb "fourth tier" drug pricing has health...
New York's proposal to curb "fourth tier" drug pricing has health plans alarmed that lawmakers might curb their ability to structure health benefits, particularly in cost-sharing for expensive medicines. Electronic prescribing has brought a new tool to health plans' efforts to keep...
Aetna is among national insurers working to chip away at the market dominance of...
Aetna is among national insurers working to chip away at the market dominance of the Regence Group and Premera Blue Cross in Oregon and Washington. Oregon's Medicaid expansion program, called Oregon Health Plan Standard, is expanding the program to about 10,000 new enrollees - the first...
Texas' health plans have long benefitted from the Lone Star State's...
Texas' health plans have long benefitted from the Lone Star State's mandatory generic dispensing law, but have gone beyond that to achieve significant generic utilization and subsequent savings from that. Texas has never been a big HMO state, but the players will keep going because the...
Massachusetts is at a crossroads with its Commonwealth Care and Choice programs...
Massachusetts is at a crossroads with its Commonwealth Care and Choice programs with enrollment exceeding expectations but costs coming in over earlier estimates. The Massachusetts Legislature is considering a number of measures to better control medical costs in the state. In addition 2009 should...
The HealthLeaders-InterStudy Market Analyst team analyzes major developments at...
The HealthLeaders-InterStudy Market Analyst team analyzes major developments at the nation’s publicly held health plans each quarter through their financial releases and conference call transcripts. The summaries focus on state highlights, product news and significant corporate...
The HealthLeaders-InterStudy Market Analyst team analyzes major developments at...
The HealthLeaders-InterStudy Market Analyst team analyzes major developments at the nation’s publicly held health plans each quarter through their financial releases and conference call transcripts. The summaries focus on state highlights, product news and significant corporate...
1941 - 1960 of 2015