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Research & Reports

Searching in Market Access (2047)

Category

2043 Market Access Reports

Anthem Blue Cross Blue Shield has pulled out of Nevada's Medicaid program,...
Anthem Blue Cross Blue Shield has pulled out of Nevada's Medicaid program, citing low reimbursements and little prospect of improvement given the state's strained budget. AMERIGROUP has jumped in to fill the void, though. Nevada's recent economic growth has been choked off by the...
Massachusetts' health reform is running on all cylinders with 439,000...
Massachusetts' health reform is running on all cylinders with 439,000 previously uninsured now covered in state or private plans. However, 2009 brings new challenges as the state mandates prescription drug coverage for individuals with health coverage and changes the rules on how businesses fund...
The list of health plans leaving the Ohio Medicaid managed care program...
The list of health plans leaving the Ohio Medicaid managed care program continues to grow with WellPoint Inc. leaving the program entirely and WellCare and Centene Corp. pulling their managed care organizations out of a portion of the eight Medicaid regions in the state. All three publicly held...
Humana Inc.'s latest stop on its buying spree was in East Tennessee where...
Humana Inc.'s latest stop on its buying spree was in East Tennessee where the Kentucky-based insurer agreed to purchase Cariten Healthcare, a provider-owned company doing business in commercial, Medicare and Medicaid sectors. Although Humana inherits more than 34,000 fully insured commercial...
Maryland regulators cited and fined Coventry Health Care after finding the...
Maryland regulators cited and fined Coventry Health Care after finding the carrier failed to comply with state laws regarding prompt payment of claims, appeals, greivances, and more. Meanwhile, AMERIGROUP has walked away from its Medicaid contract with the District of Columbia, even though the...
More than 37 percent of Medicaid beneficiaries in South Carolina who could join...
More than 37 percent of Medicaid beneficiaries in South Carolina who could join a managed care plan in the state's Healthy Connections program have done so by August of 2008. Eight health plans are enrolling members, but the competition has not diminished the growth of First Choice, the senior...
Radiology and imaging costs have begun to climb again, and health plans in...
Radiology and imaging costs have begun to climb again, and health plans in Pennsylvania are employing various measures to control that growth. Geisinger Health Plan seems to have found success with the little-used Medicare MSA, with 12 percent of the US market for that product. The state's...
Blue Cross Blue Shield of Michigan has made its own in-house provider portal...
Blue Cross Blue Shield of Michigan has made its own in-house provider portal into the go-to site for Medicare elibibility and benefit information, even for those who are not its customers. In Michigan, an attempt to dilute the healthcare purchasing power of the large public employee unions has...
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...
When Congress passed the Medicare Improvements for Patients and Providers Act...
When Congress passed the Medicare Improvements for Patients and Providers Act this summer, health plans operating in the Medicare arena began to brace for the changes. Wisconsin health plans operating special needs plans are giving the new law favorable reviews while eyeing expansion plans....
The end of private fee-for-service Medicare plans by 2011 has health plans...
The end of private fee-for-service Medicare plans by 2011 has health plans moving to re-shape their Medicare Advantage strategies, building networks where it makes sense to do so, or retreating from some areas. Several Kansas cities are considering building "three-share" arrangements to...
Florida insurers are seeing a marked movement toward self-insured health benefit...
Florida insurers are seeing a marked movement toward self-insured health benefit designs, and the worsening economy in the state could keep the momentum toward self insurance under way for some time. Blue Cross and Blue Shield of Florida is responding to the market's call for affordable products...
The managed care market in Oregon will be shaken up with the awarding of...
The managed care market in Oregon will be shaken up with the awarding of contracts for the Oregon Educators Benefit Board. Winning three-year contracts for medical and pharmacy coverage were Providence Health Plans, Kaiser Northwest and ODS Health Plans, with the huge Regence BlueCross BlueShield of...
Horizon Blue Cross Blue Shield's planned conversion to for-profit status...
Horizon Blue Cross Blue Shield's planned conversion to for-profit status stands a markedly better chance this time, as it would raise $1 billion or more that New Jersey could use to launch proposed healthcare reforms. The Medicare landscape is already shifting in response to Congressional action...
PPOs may come under more regulatory scrutiny from the Texas Department of...
PPOs may come under more regulatory scrutiny from the Texas Department of Insurance. Proposals being floated would require PPOs operating in Texas to have a certificate of authority and allow the TDI to act against plans engaging in illegal practices. HMOs are more highly regulated in Texas than...
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...
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...
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